Jen Mizell: UPMC must show moral leadership

I started my career as a nurse at UPMC almost two decades ago because I wanted to make a real difference in people’s lives. That’s what has kept me going all these years, especially through the trauma of the pandemic. But as UPMC has consolidated more and more power, staffing levels have been eroded and the treatment of front-line workers has worsened, making it increasingly difficult to deliver the quality care our patients deserve.

As the largest health system in Pennsylvania, with 33 hospitals throughout our state and growing, UPMC’s conduct sets the standard for the industry. That’s why I’m speaking out for my patients, my co-workers and my community.

Despite all the hardships, nursing is still deeply rewarding for me. Sometimes I’ll be feeling so utterly burned out and then I’ll hear an expression of gratitude from a patient or their family members and it will uplift my spirits. Just recently, the spouse of one of my patients sent me a text message saying they wanted to let me know the lasting positive impact I’d had on them. Those little interactions are a profound reminder of why I do this work.

During the course of my career, I’ve worked throughout the UPMC system, including at Presbyterian, Magee-Womens and Shadyside hospitals. For close to two years now, I’ve been part of UPMC’s travel staffing, the internal program in which nurses are deployed to different facilities where we’re needed.

These experiences have given me an overview of the severe challenges health care workers are facing across the UPMC system. Our hospitals are still dealing with the effects of the pandemic, we’re struggling with turnover, and our patients are sicker and need more care than ever.

Currently I’m assigned to the post-anesthesia care unit at UPMC Carlisle, where patients recover from surgery. In one of the most troubling examples of understaffing that I’ve experienced, UPMC does not consistently follow the guidelines set up by the American Society of PeriAnesthesia Nurses (ASPAN).

Those guidelines specify that recovery room nurses should each have only one to two patients who have just come out of surgery and that there should always be at least two registered nurses in the room. That’s because patients coming out of surgery are incredibly vulnerable and need a high level of personal attention. They are at high risk for respiratory and cardiac failure. Many have just been extubated, meaning their breathing tubes have been pulled out, and are regaining consciousness from heavy sedation.

But there are facilities I’ve worked at within the UPMC system where at times recovery room nurses are each responsible for three patients who just came out of surgery, contrary to the ASPAN staffing guidelines. On weekends and in the evenings, some UPMC facilities where I’ve worked often have only one nurse in the recovery room, despite the ASPAN guidelines stating there should be two nurses present at all times.

When there’s only one nurse, if a patient goes into cardiac arrest or can’t breathe, we have no backup. There’s a saying in health care that “Time is brain, time is heart.” That means every second counts to save a patient’s life. When you’re alone, you’re faced with a gut-wrenching choice: do I start CPR, or get the crash cart with defibrillators or get help.

You can’t do all three at once.

On top of the extreme understaffing and exhaustion, UPMC executives recently cut internal travel nurses’ pay by $13 an hour. This felt like a complete slap in the face because we signed up for the traveler program and made deep personal sacrifices — including time apart from our families — in order to help UPMC. I often have to spend several days a week away from my 14- and 17-year-old kids.

What’s so maddening is that UPMC has more than enough resources to staff its facilities safely and provide compensation that supports, recruits and retains nurses. UPMC’s revenue skyrocketed to $27 billion last year, and more than 20 UPMC executives made over $1 million each in total compensation in 2022.

I’ve lost faith in UPMC ever showing the moral leadership to use their massive resources in a more responsible way. My co-workers and I feel like we have no voice in the system to effectively advocate for ourselves or those we care for. Ultimately, we need elected officials to stand by our side to support nurses, hold UPMC and other large health systems accountable, and ensure safe, quality care for the people of our commonwealth.

Jen Mizell is a registered nurse who has worked at UPMC for 19 years and lives in Pittsburgh.