NH helps: Alkmaar hospital is struggling with high work pressure and gaps in schedules due to staff shortages

When I walk in, Judith Dekker is already waiting for me. She’s head of the dialysis department. There is a big smile on her face. So hands me white pants and white shirt with orange details. The shirt has the logo of the hospital. Judith introduces me to Dorien Sannes, a nurse in training with whom I am shadowing today.

The hospital consists of several departments. Today I am active in two of them: the dialysis department and internal medicine. Two departments where they experience the consequences of staff shortages on a daily basis. The hospital currently has a total of approximately one hundred vacancies open.

For Judith Dekker, the gaps in the schedules are a weekly battle. Closing beds is not possible in her department. It’s about life and death. It is not possible to temporarily accommodate the patients elsewhere because the rooms are also full elsewhere. And if all that isn’t enough: the pool of temporary workers is also empty. Judith is therefore happy that I am joining her for a day today.

Career switch

There are several beds in the dialysis department. A number of beds are occupied. There, kidney patients, whose kidneys do not or barely function, are connected to a special device that temporarily takes over the filtering function of the kidney and cleans the blood. Dorien is just removing a needle from the arm of one of the patients, sticks on a plaster and bandages. In the meantime, despite the busyness, she takes all the time to speak to me.

Dorien worked in the hospitality industry for twenty years when she realized she wanted something different. A few years ago, she therefore decided to start training as a nurse. She wanted nothing more than to work in the dialysis department. She is now a fourth-year student. The love for the work radiates from her. She does everything with patience and a broad smile on her face.

“Because patients undergo dialysis for four hours, you really build a bond with them. You help people. I think that’s a beautiful thing.” But Dorien is also facing staff shortages. “You can’t always give all the attention you would like to give. But that’s what you do it for.” Today Dorien works together with nurse Antoinette Schoehuijs who receives a new patient. Antoinette asks if I can come along to pick up Mrs Beers, a regular patient, at the entrance. We guide Mrs. Beers first to the scales and then to one of the beds.

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Antoinette asks me to give five anesthetic injections so that the needle in the arm feels less painful. Mrs. Beers is then placed on the dialysis machine. Meanwhile, Antoinette tells us how she experiences the consequences of the staff shortages every week. Just like Dorien, she also encounters the fact that she cannot give everyone 100 percent attention. “But I think it’s really important to have time for people.”

To ensure that there is sufficient growth of young staff, the hospital has its own training. But for this too, staff must be made available. “Maximum training requires extra work from the permanent group of employees to supervise,” explains Care Manager Simone Berkhout. In addition, the hospital tries to make working there more attractive by offering a good career path.

High workload

It’s time to go to another department, the department of internal medicine. There I am met by nurse Bibi Sluijs. Internal medicine is one of the largest disciplines within Noordwest Hospital Group. Because one of the patients on the ward, who has to be taken out of bed and put in a chair, may have contracted a bacteria, I am given a special plastic suit, mouth mask and gloves. This provides additional protection.

When the suit is on and the patient has been helped, it is time for Bibi to go home. David Abrahams takes over and is the first to check one of the patients who can be discharged after a long period of time. “Being part of that process from the start is of course wonderful,” David says in his voice, full of joy. During the check he strikes up short conversations.

“The hospital has had a high turnover lately,” David notes. He says that a number of rooms in his department have even been closed due to a shortage of staff. This means everyone has to step up. “Many more people are asking if we can work extra. This creates a high workload.”

Image of care

According to David, the solution to staff shortages lies mainly in improving the image of healthcare. In his opinion, the fact that the work is very beautiful and valuable should be proclaimed much more widely. However, a salary increase would also provide more staff, according to him. Something that is difficult to achieve from the hospital, says Simone Berkhout. “That is discussed at another table. Those are the negotiations with the unions around the collective labor agreement. This task lies in The Hague and we as a hospital have less influence on that.”

When I’ve done all my work, it’s time to end the day. One of the nurses escorts me to the changing room. I change, hand in the borrowed clothes and say hello to everyone. I then disappear through the hospital corridors and the revolving door. The working day at Noordwest Hospital Group is over.