Episode Transcript
[00:00:01] Speaker A: Welcome to Real Medicine, real lives. I'm Dr. Yasser Sambal, and together we're showing medical expertise in a human way.
Hello, everybody, and welcome to Real Medicine, real lives. I'm Dr. Yasser Sambal and today we're tackling one of the most pressing issues in healthcare. How staffing shortages affect both patients and providers. When there aren't enough hands to help, it impacts care, trust and well being on every level.
Joining us today is Adam Henry, vice president of the Amity Group Inc. A national leader in hospice nurse support, compliance and technology.
Adam's has helped agencies across the country strengthen their teams, streamline documentation and scale with confidence. From innovative tools like tag staff app to on demand staffing solutions, Adam is redefining what's possible in hospice care. Adam, it's great to have you here.
So let's start with the big picture. You know, obviously, staffing shortages and healthcare, this is a big problem. You know, I'm a physician and so, you know, we notice this all the time. So tell, let's start with, you know, can you explain why staffing shortages in healthcare have become so widespread?
[00:01:09] Speaker B: So I don't believe that there's any one specific problem.
I can speak specifically to hospice.
That's the industry that I work in. And so, you know, compassion fatigue plays a big part in that.
And then the, just the stress and the strain. The hospice nurses traveling in their own vehicle from one home to the next, seeing several patients in a row.
They may have six patients lined up for the day, and so that may take them a full eight hours.
Then when they get home in the evening, you know, take a quick shower, put some dinner on, and then now they have two, three, maybe even four hours of documentation to do. A lot of these folks are salaried and not on hourly wages. So they're basically kind of working for free, taking time away from their family, and then they have to get up the next morning and do it all over again. If they're not on call that night, if they're on call, they may be called out 2, 3, 4 times and get relatively zero sleep.
So the idea that there's a nursing shortage, you know, there's thousands of nursing students that graduate every semester.
I believe what, what we have is a shortage of nurses that are willing to work under the current corporate grind that we have put them in.
[00:02:37] Speaker A: Gotcha. And so you talked about compassion fatigue. And so can you explain to the audience what compassion fatigue is and how it affects people's work?
[00:02:48] Speaker B: Certainly. So while I'm not clinical, I can tell you what I see in our nurses and in my wife, who's been a hospice nurse for over 34 years.
So these hospice nurses, they go into these patients homes and they, you know, just because someone's on hospice does not mean that the end is happening. Now it may be a year, it may be 18 months, could be nine months, it could certainly be just several days. But they become almost like a family member. You know, they're in these people's home. The most intimate setting.
There's two significant happenings in a person's life. Being born and passing on to whatever's next. So this is a real intimate time.
And so there is, although it is professional setting, there is some attachment and inevitably this patient will pass on and there will be another patient to fill in next.
But this repetition, this repetition of becoming involved in this person's life and then losing them without a good outlet to process their own grief.
I think that there's some, you know, well, I'm a professional, I should just be able to handle this. But we're all people and we all feel, and people who are drawn to hospice are just inherently compassionate to begin with. So it's only natural.
[00:04:16] Speaker A: And so how does this, you know, shortage of providers, whether it be nursing staff, ancillary staff, physicians, etc. How does that affect the quality or even just the experience at the bedside for patients?
[00:04:31] Speaker B: Well, sure. So, you know, when we don't have a good nurse or physician ratio to patient, there's less time available for the professional to spend at the bedside. And so I can certainly see where a patient would feel like, you know, hey, I need more time, or I don't feel like you asked me all the right questions or enough questions, or you didn't really spend enough time with me. And that's not necessarily the professional's fault. I mean, most people in healthcare are professional, want to do a good job, are compassionate or empathetic, but because of the way the structure is a corporate structure, there's just not enough time available. And you know, when there's a shortage to begin with, and then also with the aging population and the boomer generation, these demands are just increasing. So we're gonna have to make some changes.
[00:05:32] Speaker A: That's very interesting that you say that. So I'm curious, you know, since you're kind of a corporate person and you know, I'm a provider, so I'm curious from perspective. You know, hospitals now will call patients after they got discharged or et cetera, and send them surveys and send them things to rate their stay, whether it's the food, the amount of time the provider spent with them, the nursing staff, etc. And how do you. How do you find a balance? Because you brought up, you know, people are obviously overwhelmed, right? There's a lot of patients, there's not enough providers, or there's not enough healthcare workers, or at least in this field, et cetera. And so how do you balance, as a corporate person to take that feedback from patients to be able to a improve the quality despite the shortage that's available?
[00:06:18] Speaker B: Sure.
So that's why we designed our business model at the Amity Group the way we did. What we saw was a mass exodus of hospice nurses leaving the industry due to burnout for one reason or another.
And we wanted to give these nurses a platform to come back and do the. The work that they love, see their patients, and then go home to their families and live their lives.
So we came up with a business plan that allows them to have the autonomy to choose the days, hours that they want to work. If a nurse wants to work three days a week or two days a week. We actually had a one nurse. Her and her husband were retired and they had an RV and they like to travel around the country.
But she still wanted to see patients. So she came to us and she said, hey, I want to see patients two days a month.
[00:07:10] Speaker C: Right.
[00:07:10] Speaker B: Which sounds almost unreasonable, but it's not unreasonable for us at Amity because there's always a client that says, hey, I have a nurse out with an eye appointment. Or, you know, I just found out that I have a nurse that is.
Has a school play for a child.
Do you have someone for one day? And we did, you know, so, yeah, we try to fill in those gaps where we really provide the most benefit for hospice agencies. You know, hospice is really unpredictable in census.
[00:07:43] Speaker C: Right.
[00:07:44] Speaker B: It could be skyrocket in the morning and then drastically drop that afternoon. That's just the nature of hospice. And so when a hospice agency partners with the Amity Group, they can have a partner that can fill in those gaps. When they're evenly staffed and their census goes up, then one of our nurses can step in on day one, ready to go, take care of that patient load and not put such a strain on the core staff that they have in place. That way they can keep their staff happy and reasonably rested, you know, for the following day, and our nurses can take up those.
Those influxes.
[00:08:28] Speaker A: So let's take the opposite side of that. So we talked about patient perspective and how you modify for that so what about your provider perspective? So how does it feel or the feedback you get from your providers or your nurses that they really want to do a better job and they want to give their best, but they simply just can't because of adequate inadequate time or inadequate support. And how do you deal with that?
[00:08:50] Speaker C: Right.
[00:08:51] Speaker A: And what does it feel like for them?
[00:08:53] Speaker B: So our, our partners, our hospice partners love working with Amity Group because unlike other staffing agencies, that one just send a registered nurse.
[00:09:06] Speaker C: Right.
[00:09:06] Speaker B: Which is great. All of our nurses are hospice specific, you know, hospice experienced. And so we don't lock our, our clients into a 13 week or a 40 hour week minimum.
[00:09:21] Speaker C: Right.
[00:09:22] Speaker B: So they only pay for what they need. If they say, hey, our senses has risen a little bit and we need someone on Tuesday and Thursday for the next three weeks or just one week, we can help them with that. Or they may have greater needs, they may say, hey, I have a nurse out on maternity leave and you know, we need somebody five days a week for the next six weeks.
And so let's just say for whatever reason they make a new hire during that six week period and they no longer need us. It's no harm, no foul. We're really there. We're trying to bridge that gap between helping the nurses do what they love and then helping the hospice agencies provide the care that they want to give.
[00:10:02] Speaker C: Right.
[00:10:04] Speaker B: And so when they have these surges, right. And then a nurse steps in, they, it gives that extra set of hands, right. We have also developed an acuity tool for hospice which otherwise doesn't exist. I think you're probably familiar in the hospital with that.
If we can start standing up for some nurse to patient ratios in hospice, that will drastically help that in going in hand with the acuity tool.
And then we've also developed this, the dawn app, right, this documentation app for hospice nurses to one, help the hospice agency assure that they are supporting eligibility in their documentation and then also helps speeding up the nurse's documentation. So then, you know, if they were spending three hours a night, maybe they'd only spend an hour to an hour and a half at night doing their documentation.
[00:11:03] Speaker A: And so let's try to, you know, before we close out this segment quickly, I just would like to think of what's one change you believe that can actually bring hope back and for both patients and providers under this current circumstances.
[00:11:15] Speaker B: I think right now the, the main thing that we need to work towards is the nurse to patient ratio.
I think it's just out of balance right now. And that way we would assure that we have enough nurses to see the patients, and then it would also more evenly spread the burden that's on each nurse to see the patients.
[00:11:38] Speaker A: Okay, great. All right, everybody, you're with real medicine realize. I'm Dr. Yasser Sombal. Up next, we're going to talk more with Adam about how overworked providers really struggle to truly listen to their patients. And we're going to dive deeper into that. So hang out. We'll be right back after these messages.
Stick with us. We'll be right back with more real stories, real breakthroughs and real lives transformed.
And we're back. I'm Dr. Yasser Sombol. Let's dive right back into today's medical conversation.
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Welcome back, Adam. So in this segment, we're going to discuss how staffing pressures affect human connection in healthcare. Patients often feel rushed and unheard, and trust can be broken there, obviously. So how can we rebuild it?
So one of the first things I'd like to ask you about is, you know, obviously this is something as a provider I completely understand.
[00:13:11] Speaker C: Right.
[00:13:12] Speaker A: So, you know, I mean, I, you know, when I have a busy clinic or, you know, I'm rushed in the hospital and you want to try to answer as many questions as possible, but sometimes you just kind of feel overwhelmed. And so how does short staffing often mean patients feel more like a number than a person?
[00:13:31] Speaker B: Yeah, certainly. Well, you know, when the nurse to patient ratio is a little bit out of whack and a nurse has more patience than there is time in a day, they're going to be rushed. They certainly want to spend time with the patient.
One of the problems that we see that we hear from our nurses that come to us, one of the reasons that they've left the industry and want to come to work for a company like ours because is the point system, right? They have to meet so many criteria points, and so that is rushing them as well the documentation is immense these days.
When Shelly first started her hospice career in the field, documentation was done on paper. So there's only so much room on a sheet of paper.
[00:14:31] Speaker C: Right.
[00:14:32] Speaker B: But now with electronic medical record keeping, there's an indefinite amount of characters. And with the scrutinization over these medical records to support eligibility, there's an ever increasing demand of more and more information that is being provided in the medical record. And, you know, I'm certain that you've heard, you know, if it wasn't documented, it wasn't done.
Certainly it was done.
[00:15:03] Speaker C: Right.
[00:15:04] Speaker B: You know, but this, this burden to put on these medical professionals to, to do this endless amount of documentation, you know, that's playing in the back of their mind the whole time, right. It's an extra stress.
Not to mention, you know, in hospice, a lot of these folks, very compassionate, very empathetic, and they often tell their patient, hey, if you need anything, call me. Well, they're at the patient's home.
Maybe this is patient number two, Mr. Smith. And now they're on patient number four. Well, Mr. Smith forgot what the hospice nurse told him about his medication. So now he's calling.
[00:15:48] Speaker C: Right.
[00:15:48] Speaker B: Well, now she has to pull over the side of the road. You can't just talk on the phone and drive and look at Mr. Smith's records and remember what she told him. And, you know, so there's a lot, a lot of stress that patients aren't aware of.
[00:16:03] Speaker C: Right?
[00:16:03] Speaker B: Not to mention the compassion fatigue. Maybe the patient that they saw before then, maybe that was a death visit. You know, so there's a lot of just inherent pressure that the patient is unaware of.
[00:16:21] Speaker C: Right.
[00:16:22] Speaker B: I hope that there's not any medical professionals that are going into a patient's home and, you know, bringing with them the baggage of whatever they just left or from home or whatever that may be. I'm, I'm sure they're not, but it's there, right? Whether they, you know, they hold their shoulders back and their chin up, and I'm a professional, I can handle this. They're still human, right? So when you have all of that going on and you're short staffed, the pressure is just tremendous. And I can certainly understand how and why a patient would feel like, you know, hey, maybe I just don't matter as much as I thought I did.
[00:17:05] Speaker A: And, and so to the next point. So then how does this rush care affect trust healing between patients and providers?
[00:17:13] Speaker C: Right.
[00:17:14] Speaker B: So, you know, while I'm not clinical, but, you know, work in the industry and I'm aware That, you know, a very common phrase is best practice is documentation at the bedside.
[00:17:27] Speaker C: Right.
[00:17:28] Speaker B: Well, if I put myself in the patient's shoes and you're making a visit with me, and you know, I have these needs, and you check me out real quick, you're in a rush and you whip out your tablet, and now you're doing your thing on your tablet, There is a disconnect. I don't feel like you're paying attention to me.
And you're also rushed and you're also stressed out. Your. Your cell phone's buzzing because Mr. Smith forgot his medication.
And so, you know, maybe one of the patients that you saw yesterday that you also gave your phone number out to has fallen, and instead of calling, the hospice agency called you. You know, so there's a lot of back and forth. There's a lot going on in the background that the patient can be unaware of.
And so what if I was speaking with someone who was expressing that to me, a patient, what I would say, you know, assume the best. Right. Let's assume that this care provider has your best interest at heart, but is just under so much stress, they're doing the very best that they can. What I would suggest is giving the hospice agency a call and ask to speak to the social worker.
[00:18:47] Speaker C: Right.
[00:18:48] Speaker B: Social worker can definitely help you navigate some of these difficulties and kind of make sense of that.
While they are also very busy, as the chaplains are, which is another very good resource for these things, their business model is a little bit different, where it's more of a sitting environment, a conversation like you and I are having, and help them navigate, and then also advocate for you at the agency level that, hey, this person needs more help or they feel a little bit left out, or they notice that the.
The care is rushed or they feel that way anyway, which is valid, you know. And so, yeah, I think that that's what I would. That would be my best advice for a patient who feels a little.
Maybe shorted on their visits.
[00:19:37] Speaker A: And would you. Would you recommend any changing in staffing, for example, that could provide that extra time for providers to be able to spend with their patients?
[00:19:47] Speaker B: Absolutely. So obviously, all that I'm going to say here is it's much easier for a larger agency with. With a large staff, but even a small staff could start off with one, you know, one step at a time, using an acuity tool.
[00:20:03] Speaker C: Right.
[00:20:04] Speaker B: Really measuring, you know, obviously 10 miles in Houston traffic versus 10 miles in Mamu, Louisiana, drastically different.
[00:20:14] Speaker C: Right.
[00:20:14] Speaker B: So 10 miles is not just 10 miles.
And then you know, the care provided, you know, someone who, a patient who is in their 70s and has had COPD for the last decade does not necessarily need the emotional support. As a 32 year old that has just found out that they have stage four pancreatic cancer. Cancer, Right. A, a middle aged parent that has young children, where does that measure on the acuity tool? It's not just a patient, it's not just an in and out visit. There's a lot of different factors, right?
Having a, you know, if you have a staff of five nurses or more, there's going to be that one nurse that thrives, loves these high pressure, high acuity situations. Make that person your designated high acuity nurse, right. And let them take care of those patients where as the other nurses can do more of the routine visits.
Also having a designated on call nurse, right. Versus just rotating through the staff can imagine a nurse works a full day seeing their patients, going home, putting on dinner, taking a shower. The phone rings, gotta go visit a patient, you know, get home now it's 11 o'. Clock. Not only does that documentation have to be done, but the documentation from the day is still not finished. Crawling in bed 12, maybe 12:30, the phone rings again.
Got to get back on the road and go see another patient.
These nurses want to see their patients, but I think that the toll that it's taking on them is just, it's significant, right? And so, you know, having some designated people for some of these roles, I know a lot of our agencies that we work with are shifting to having a designated admit nurse, right? An admit may take a nurse an hour and a half to admit a hospice patient, but there's three hours of documentation that follow that, right? So you know, if a nurse is out on the road and the next admit is close to her last visit, if they don't have a designated admit nurse, that nurse is going to get that admit. So now not only did she have the whole day's worth of work, she has an extra admit and an additional three hours of documentation to be done.
And if she's on call, that's just like, you know, a triple whammy, right? She has to get up and go back to work the next morning and begin seeing patients again.
And so I think that that needs to be recognized and we need to more normalize that as hey, you're human, yes, you're a nurse, but you don't have to save everyone all the time. You also need to take care of yourself.
You can't pour from an empty Cup.
[00:23:24] Speaker A: So to close out, what, in brief, you know, what. What message would you give patients who feel invisible in the healthcare system?
[00:23:31] Speaker B: I would say, you know, reach out to the hospice agency, set up a meeting with your social worker, your chaplain, express your feelings, tell them how you're feeling, and get some validation and let them advocate for you at the agency level.
[00:23:47] Speaker A: Okay, great. All right, so, Adam, just for the viewers, can you tell them, you know, where they can contact you, communicate with you if they want anything to, you know, provide patient provider connections, et cetera, more guidance on what you're talking about?
[00:24:01] Speaker B: Yeah, absolutely. They can feel free to Visit our website, amitystaffing.com and fill out a submission form there and submit that, and someone from our office will get back to them right away and see how we can best guide them to the appropriate agency or person or however we can help.
[00:24:23] Speaker A: Okay, great. Hang out, everybody. Next, I think we're going to talk about a very important topic, and that's why, you know, nurses are actually leaving the profession and what that means for patient care moving forward.
So hang out. We'll be right back.
And we're back. I'm Dr. Yasser Sombol. Let's dive right back into today's medical conversation.
And we're back. I'm Dr. Yasser Sombol. Let's dive right back into today's medical conversation.
All right, everybody, welcome back to Real Medicine, Real lives. So, Adam, our next topic is really a big deal, and it's been going, you know, on for a while now. So nurses are really leaving their profession in large numbers, and it's obviously impacting patient care everywhere. I mean, me as a provider, I know that very well because, you know, half the time when you want to admit a patient to the hospital or do something, they'll say, we don't have beds. And really, every hospital has beds. The issue is really, you know, there's no staffing. And so, you know, let's talk about some things are what are the biggest reasons, for example, why nurses are choosing to leave healthcare today, in your opinion?
[00:25:31] Speaker B: Sure. So, you know, one of the craziest stories that I've heard was, was an experienced nurse left the industry to become a truck driver. Now, there's certainly nothing wrong with being a truck driver, and all work is noble.
[00:25:45] Speaker C: Right.
[00:25:45] Speaker B: However, that to me, is just one extreme to the other.
And so the nurses are looking for ways to lower their stress.
[00:25:58] Speaker C: Right.
[00:26:00] Speaker B: I think that the way we have them kind of boxed in and really dumping more and more work with the best Intentions.
[00:26:13] Speaker C: Right.
[00:26:13] Speaker B: We want good documentation, we want good care.
I think that with the shortage as it is, there's just not enough.
There's just not enough water in the well, so to speak, for a lot of nurses to carry this weight, which is also bad because as experienced nurses leave and all these newer nurses are graduating and going into the field, there's not enough training available, not enough shadowing.
[00:26:47] Speaker C: Right.
[00:26:47] Speaker B: There's not enough experience, relationships for a younger nurse to go to someone more experienced, someone say, hey, you know, what do I do? I've never been in this situation.
Hospice nurses, full autonomy. They're out there on the road by themselves making decisions. And sometimes, you know, the reality is, is that maybe the patient is not suffering from some mental illness, but maybe the family members or the direct caregiver is, which is also just adding stress to the nurse. You know, they're there to see this patient and do the best care, best job that they can. But they have this other dynamic that's going on.
I had my wife tell us this story where she had a patient whose wife had schizophrenia. And so when she was on her medications, everything was fine, but Shelly would just move real slowly and just not to, you know, disrupt. But when she wasn't on her medication, not only did Shelly have to go to the house and knock on the door, but they wouldn't answer. Shelly had to go two doors down and get the brother in law to come over to talk to the wife to get her to open the door and let you know. So it doesn't sound like a very big deal, but that's an extra 30 minutes out of the day and, you know, more stress on the nurse. And it's a lot to burden.
[00:28:18] Speaker C: Right.
[00:28:18] Speaker B: So it's a lot of weight to carry. So I think nurses are, you know, they get burnout.
And so what happens is they'll, they'll leave the hospital and they'll, they'll go to hospice or vice versa, they'll go to dialysis. And what they find is that everywhere they go, this stress may be different, but it's often quite the same. It's just kind of jumping out of the frying pan into the frame fire. And so then they start looking to other ventures.
[00:28:45] Speaker C: Right.
[00:28:46] Speaker B: You know, I have college degree, very well educated, certainly capable of doing other things.
Lots of them go into entrepreneurship.
So, you know, there's, it's a puzzle that we need to figure out.
[00:29:00] Speaker A: Yeah, I think it's really, you know, interesting that you brought up that point about mentorship. And I think that Actually transcends across all healthcare. So me as a provider or physician, you know, I'm an interventional cardiologist and you know, when I go look back at my years of training and, you know, we don't just people expect you to graduate medical school and then know what you do. And that's not really how it works. We go through years of training and years of, you know, super being supervised and learning as you go. And you know, even as a proceduralist, you know, you, you, you want to do a lot of cases, but you want mentorship in areas that you may not have dealt with before. Or so I think it's really interesting that you brought that up because that's really an important part of, you know, every, everybody's individual growth in the health care field because mentorship is really needed. And it's the same as any other profession out there that requires some sort of mentorship. When you first graduate and start out with textbook learning is not the same as practical world learning. So. Yeah, I agree. And so coming to that point with, you know what, what do you think hospitals or agencies or whatever can do to make nursing a more sustainable career again?
[00:30:12] Speaker B: Okay, we have a client in New Orleans who, they have a really interesting thing that they have done with their business model. They use one of our nurses, they use an Amity nurse every Monday and they rotate through their staff. In other words, each nurse on their staff gets a Monday off to just be with their family or recoup, be at home. One of our nurses steps in, sees that patient or that patient load for that day. And so that's a real seamless way of just keeping your, your staff fresh.
And then, you know, also using Amity, when you have a rise in census, you know, to fill in those gaps, you have someone out on vacation, attorney leave, we fill in those gaps. And it really helps the nurses feel validated that, hey, what I do is important and I am also not just a number.
[00:31:10] Speaker C: Right?
[00:31:11] Speaker B: That old saying, load the wagon, don't worry about the mule, it's time to worry about the mule because the system is breaking.
[00:31:18] Speaker A: Yeah, no, I agree. And I think that could apply not only to hospice care, but even just to hospitals, clinics, etc, when your census is really high, to have some sort of backup in place in order to carry that load to get you through that day. So in that note, how can staffing solutions create a better balance and keep nurses where they're needed most?
[00:31:41] Speaker C: Right.
[00:31:41] Speaker B: So if you're evenly staffed and you know, your census is where it needs to Be with the staffing model that you have when your census does go up and with the aging population of the boomer generation, the needs across the board in medical are going to continue to rise. And so having a partnership with a company like ours, whether it's niche.
[00:32:05] Speaker C: Right.
[00:32:05] Speaker B: We only do hospice. We do one thing. Hospice nurses. When you have a partnership like that, you can grow.
[00:32:15] Speaker C: Right.
[00:32:16] Speaker B: And comfort knowing that you have a partner who can step in on day one and take over that patient load. So you're not increasing the burden of your core staff and keep them.
Keep them happy as well.
[00:32:32] Speaker A: Yeah. So let's make this a little controversial. So you brought up, you know, documentation and all these things, which is something everybody in healthcare has to suffer with.
[00:32:41] Speaker C: Right.
[00:32:42] Speaker A: And. And electronic medical records and E ordering and all this stuff that has become, you know, somewhat easier, but also somewhat more complicated. And so would you. Would you think, in your opinion, that there's too much red tape and bureaucracy that goes into health care that makes it overwhelming for providers to do their job? I mean, when you. When you have to sit there and document over and over and document repeatedly, document all day long.
[00:33:10] Speaker C: Not.
[00:33:11] Speaker A: Not that documentation isn't important, but there's a lot of things to go through just to get to where you need to get things to get done.
[00:33:19] Speaker C: Right?
[00:33:19] Speaker B: Correct. Yeah.
So Shelly, my wife, also does a lot of public speaking and big advocate for hospice nurses and really speaking up about the redundant documentation.
[00:33:35] Speaker C: Right.
[00:33:35] Speaker B: If you entered this information here, and now you have to enter it again here and again here. You know, could we maybe auto populate some of that? I mean, documentation is vital information that definitely needs to be accounted for, done correctly. However, you know, a lot of the outside forces that are requiring this documentation have little to nothing to do with health care. A lot of it is bureaucracy.
The large corporations, insurance corporations that own these medical facilities and providers requiring all these things. Of course, you know, the surveyors who do these record reviews, I'm not saying that they get paid to get money back for their client, but I'm sure that there's some incentive to do their job and do it well. And to the increase, you know, if you documented that education was done right, so that was good a few years ago. And then another surveyor came back and said, oh, that's not quite good enough. Who did you provide the documentation to?
Who did you provide the education to? So, okay, so now you got to add that. And then, okay, well, how do I know? You really did do the education?
So now you have to really go into the Specifics. So it's just an endless amount of additional documentation that needs to be done.
You know, when nothing about the care has changed, you've just really hindered the care itself because you just adding to the burden of the medical provider.
And that, that has to be changed. There's something there that we're going to have to work out. And that's partly why we developed the, the dawn app.
[00:35:34] Speaker C: Right.
[00:35:35] Speaker B: It's not AI, it's. It's ei.
[00:35:38] Speaker C: Right.
[00:35:38] Speaker B: Export Expert Intelligence.
[00:35:40] Speaker C: Right.
[00:35:41] Speaker B: It's Shelley's intellectual property that we've used some AI tools to make readily available the information that a hospice nurse needs to document to support eligibility for hospice. So one, the hospice agency can sleep well at night knowing that their documentation has been done and done well. And it also speeds up the process. It cuts the nurse's documentation basically in half.
[00:36:11] Speaker C: Right.
[00:36:12] Speaker A: No, I completely agree with you. I mean, insurance agencies, you know, all this documentation, all this unnecessary repeated paperwork is really, you know, I think it's a real big burden and I think it makes, it actually really adds to the burnout, in my opinion, beyond, you know, patient care and beyond what patients need, which I think most healthcare providers love, and it's why we do it. But I think the other outside forces really make it, you know, stressful to do this job. So. So I completely can relate to that. All right, so we're going to be right back in this final segment. We're going to try to, we're going to discuss with Adam more about, you know, how families and we can help them regain, you know, faith in the healthcare system that sometimes just feels to be broken. So give us a few minutes. We'll be right back.
Stick with us. We'll be right back with more real stories, real breakthroughs and real lives transformed.
And we're back. I'm Dr. Yasser Sombol. Let's dive right back into today's medical conversation.
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Welcome back, Adam. So in this Final segment, we're going to address the heartbreaking reality families really have, you know, and they've lost faith in the healthcare system. And let's try to see if we can figure out how staffing improvements and protective leadership can really restore trust.
So, you know, in your opinion, why do patients and families feel so disconnected and disappointed with healthcare today?
[00:38:24] Speaker B: Well, one is turnover, right? When you're short staffed and you inevitably lose a nurse because you are short staffed now, you're even more short staffed, right? So, you know, you have one nurse and as soon as you get accustomed to her, that's a different nurse.
Obviously I have a staffing agency, right? So it's a different nurse. But however, our nurses aren't branded as the MT group. They're, they wear our, our hospice clients credentials on their scrubs. And, and they don't, you know, say, hey, I'm a, you know, I'm not your forever nurse. You just say, hey, I'm stepping in today, just kind of help ease in the gaps.
You know, I'm gonna take good care of you. But yeah, so, you know, it's, it's natural when you have all these different pressures on the medical provider, there's excessive documentation, these impossible patient loads, long travel time, you know, all the different things that are going on in the background with medication orders and other patients calling in.
So I think another good thing that specifically hospice agencies could do is having a dedicated person in the office who's good with people, good on the phone to field some of those calls. Instruct your nurses to don't give out your personal cell phone number to these patients. Have them call the office and deal with someone who's really personable. And then to the patient and the families, I would say, like I said before, you know, reach out to the social worker, reach out to the chaplain, and you know, a lot of local governments, you can go to their website and you can research, they have links to social workers that work for the state, work for the city, and if they don't have some resources, because there's a lot of unknown resources that are available if a patient or the patient's spouse was a member of the military, there's a lot of unknown VA benefits that are also available.
If you're a church member, reach out to some clergy and even if you're not, reach out to them anyway. And they also often have resources that are not really well known, well talked about, you just have to ask. So, you know, speak up. I, I think that you obviously catch more flies with honey than you will with vinegar. So, you know, naturally, if you feel slighted, that's a normal human experience.
But if you call and just express how you feel and what you would like to see changed, I think that if you approach it from that way, you can definitely take some steps in the right direction to get in the care that you believe that you need.
[00:41:21] Speaker A: And how does leadership in healthcare, for example, what can they do to help rebuild the confidence with their communities?
[00:41:30] Speaker B: Right. So, you know, what we say at Amity is that it's not a weakness to partner with a staffing agency.
[00:41:38] Speaker A: It's.
[00:41:38] Speaker B: It's actually a show of strong leadership. You value your team. And if you value your team, part of looking after them is lessening the burden, at least not overburdening them.
If you bring in some extra hands when your census is high, that really makes for a happier, more concessive staff and so just better care all around.
[00:42:05] Speaker A: So I know your focus is in hospice, but maybe we can just kind of get your opinion as an, you know, an agency group.
How often do you think, let's just say a hospital system or a hospice group or whatever should use an agency person? Let's say per week, should there be at least one agency person in the hospital carrying a burden per week to help offload from some of the regular staff or in a hospice agency, Would you think that that's a normal rotation that should be happening to help ease the burden and maybe improve care, give people more time, etc.
[00:42:42] Speaker B: Oh, absolutely. Yeah. I think that anytime that you, you know, if you bring in a, an agency person, provided that they, like us, Amity are niche and fit your business model.
[00:42:57] Speaker C: Right.
[00:42:58] Speaker B: We would never send one of our nurses to the hospital.
Sure, they, they would do their very best, but it wouldn't be the best fit if you use a niche agency that way, you know, you're getting a well qualified person to step in. I think it shows the rest of your staff that you care and validate them.
I know that, you know, there's endless amounts of meetings in every medical profession.
How about having a check in? You know, how are you guys doing? We do that at Amity.
We part of our HR folks there in Philadelphia at our Philadelphia branch. And it's their job. When you see a nurse has been working X amount of hours for however many weeks, they get a call like, hey, you know, do you need a break? We see that you're working all these hours and a lot of times they do. Sometimes they're doing it because they want to Right. A lot of nurses want to work five days a week or six days a week, but a lot of folks feel like they're letting their employer down, they're letting their patients down. If they say, hey, you know, I need a break, we need to normalize that. And I'm not suggesting that we, you know, just go the way, opposite direction. That is not, you know, it's a business.
[00:44:19] Speaker C: Right.
[00:44:20] Speaker B: And there has to be a profit, otherwise the medical system won't exist.
So I'm not suggesting that we just, you know, handle everyone with kit gloves. However, we do need to recognize that we're all human and we all need a break and we need this, an outlet. You know, maybe once a week, have a check in with the social worker, with the staff.
[00:44:45] Speaker C: Right.
[00:44:45] Speaker B: Hey, how are you guys doing? You know, we lost six patients this week. Where y' all at with that? Is everybody okay?
You know, just make a safe environment.
[00:44:55] Speaker A: Do you think the disconnect. So I would imagine there's got to be some sort of. I mean, you can't take an agency nurse and put her in a role without there be some preliminary training, you know, orientation, all this stuff to whatever that hospital system or hospice care program or whatever needs. Do you think the delay in that or the lack of using that is that process in which there's all this, you know, pre work that needs to be done in order for them to wake up and say, okay, I'm going here today and I can get that job done?
[00:45:29] Speaker B: Yeah. You know, when we first started the Amity Group, we got a lot of that from potential clients that we reached out to that, hey, we'll never use staff staffing because we require all this training.
[00:45:44] Speaker C: Right.
[00:45:45] Speaker B: And so through education, we have been able to break through and explain that, you know, we do one thing and we do it really, really well. That's hospice nurses. And I'm sure that there's some other fantastic agencies that maybe are dialysis specific or hospital specific, because, you know, there's a. Like you were saying earlier, you know, the medical learning, the textbook learning, that's one thing. But. But that experience and that skill set and the art of what you do.
[00:46:16] Speaker C: Right.
[00:46:16] Speaker B: That doesn't always transfer from one field to the next. And so through education, we've been able to place hospice trained nurses in hospice agencies, and they're familiar with multiple EMR systems.
Shelly is, you know, if you're not familiar, she's a complete documentation nerd.
[00:46:43] Speaker C: Right.
[00:46:44] Speaker B: She's written two books on hospice documentation which, you know, those two books are the heartbeat of our app, the documentation app for hospice nurses. Dawn.
And so, you know, kind of lost it.
[00:47:02] Speaker A: That's okay. That's okay. So. So that's okay. No, but I mean, it makes sense because I could see that being a hindrance, right? You know, trying to. You have to train people, get them ready just to bring them in. It's a lot of pre work just to get to the actual point to be able somebody just to walk in somewhere and do it. I mean, so I could see that being a hindrance for people because they're like, oh, I got to go through this whole process, etc.
Maybe, maybe you can just kind of share from your experience that a situation where you've walked in and you've helped with staffing improvements that's really improved that organization and the healthcare given by that organization, or you've gotten feedback that this was really the right decision to make. You know, maybe you gave an example earlier about how you have one organization that usually at least once a week where they give their nurses off every Monday, etc. Maybe they give you some feedback into how just improving that process has made things better for them.
[00:47:58] Speaker B: Well, it has significantly increased their retention.
Happy staff leads to higher retention, you know, and so yes, they.
All of our clients are 100% repeat clients.
Obviously we've had a few hiccups here and there, but we are very hands on and proactive in correcting those and.
[00:48:29] Speaker A: Okay, no, no, I mean, it's important. I mean, obviously you're firsthand in this stuff, so that makes complete sense that you know, you would get feedback like, hey, we've actually not only sourced our staff being happier, but our patients are happier.
[00:48:42] Speaker C: Right.
[00:48:42] Speaker A: And so I completely agree with you. I think that's an underused thing and they really should focus on. I realize, you know, the expenses may come in, but it's probably long term, would pay off really well, just not only for the system, but for healthcare and for patients. And you know, that investment would be a really good idea. So, Adam, so this has really been a great conversation and I really enjoyed this actually, and I can relate to a lot of this. So can you give us some more where the viewers can go to learn about your work, continue improving patient care in their communities, et cetera, how they can get in touch with you?
[00:49:15] Speaker B: Yes, absolutely. And go to our website amitystaffing.com S A M I T Y S T A F f I n g.com and fill out a submission form and someone from our office will be reaching back out to them.
[00:49:29] Speaker C: Okay, great.
[00:49:30] Speaker A: Adam, thank you so much for sharing your expertise and solutions today. You know, we've covered everything from staffing shortages and the human connection to nurse retention and rebuilding family trust.
To our viewers, healthcare works best when every patient feels seen, every provider feels supported, and every system is designed to care for people first. Implementing these insights can make a real difference in both patient outcomes and provider satisfaction.
I'm Dr. Yasser Sambal, and this wraps up our episode of Real Medicine, Real Lives. Stay informed, stay engaged, and keep advocating for care that truly matters.
