紐時賞析／疫情影響未消失 全美療養院人員短缺、過勞問題延燒

疫情之後，全美療養院人員短缺和員工過勞等問題仍處於危機水平，且許多機構難以維持運作。示意圖。圖／Ingimage

Staffing Shortages at Nursing Homes Persist

全美療養院人員短缺議題 持續延燒

Many Americans prefer to believe the COVID-19 pandemic is a thing of the past. But for the nation’s nursing homes, the effects have yet to fully fade, with staffing shortages and employee burnout still at crisis levels and many facilities struggling to stay afloat, according to a report by federal investigators.

許多美國人寧願相信新冠疫情已是過去式。但聯邦調查人員報告指出，對這個國家的療養院而言，疫情帶來的影響尚未完全消逝，人員短缺和員工過勞等問題仍處於危機水平，且許多機構難以維持運作。

The report, by the inspector general’s office at the U.S. Department of Health and Human Services, found that the flawed infection-control procedures that contributed to the 170,000 deaths at nursing homes during the pandemic were still inadequate at many facilities. And while the uptake of COVID vaccines was initially robust when they first became available, investigators found that vaccination booster rates among staff workers and residents have been badly lagging.

這份美國衛生及公共服務部總督察長辦公室的報告發現，有缺陷的感染控制程序，在疫情期間導致療養院有17萬人死亡，如今在許多設施相關程序仍不足。而儘管新冠疫苗一開始投入使用時接種踊躍，但調查員發現療養院工作人員和住民疫苗追加劑接種率嚴重落後。

The findings were directed at the Centers for Medicare & Medicaid Services, the agency under the department’s jurisdiction that oversees 1.2 million nursing home residents whose care is provided mainly by the federal government. The inspector general’s report described the staffing problems as “monumental,” noting high levels of burnout, frequent employee turnover and the burdens of constantly training new employees, some of whom fail to show up for their first day of work. For nursing homes, the inability to attract and retain certified nurse aides, dietary services staff and housekeeping workers is tied to federal and state reimbursements that do not cover the full cost of care.

這些調查結果是針對美國聯邦醫療保險和補助服務中心，這個單位隸屬衛生部、監管全美共120萬名主要接受聯邦政府提供照護的療養院住民。這份總督察長報告描述，人員問題「很重大」，並指出極度勞累、人員流動率高及訓練新員工的壓力持續存在，甚至有新員工首日上班就沒出現。對療養院而言，無法吸引和留住經專業認證的護理員、飲食服務員工和房務員，與聯邦和州政府補助未涵蓋全部護理費用有關。

Rachel Bryan, a social science analyst with the inspector general’s office, said the report sought to ensure that key lessons from the pandemic were not lost, especially now that the acute sense of urgency has faded.

衛生部總督察長辦公室社會科學分析師瑞秋．布萊恩表示，該報告希望確保新冠疫情帶來的重大教訓不被遺忘，特別是在急迫感已消逝的狀況下。

“Just as airplanes cannot be repaired while in flight, nursing home challenges could not be fully repaired during the pandemic,” she said. “We feel very strongly that as we come out of emergency mode, we take the time to reflect, learn and take real steps toward meaningful change.”

她說：「就像飛機無法在飛航中修理一樣，療養院的挑戰可能也無法在疫情期間完全修復。我們強烈地感覺到，隨着我們走出緊急模式，我們要花時間反思、學習並真正採取行動做出有意義的改變。」

The Centers for Medicare & Medicaid Services officials asked that some of the proposed recommendations be removed from the report, saying improvements were already in the works.

美國聯邦醫療保險和補助服務中心官員要求，報告中提出的一些建議應該刪除，並稱改善措施已經開始發揮作用。

The agency, for example, cited a new federal program that will provide $75 million in scholarships and tuition reimbursement for those pursuing careers in nursing.

例如，該機構舉出一項聯邦計劃，將提供7500萬美元獎學金和學費補助，給有意從事護理職業的人。

文／Andrew Jacobs 譯／羅方妤