“WHEN YOU’RE SURROUNDED BY THAT TRAUMA FOR A LONG TIME, IT’S HARD TO BREAK OUT.” — SANDRA RISOLDI, NURSE ratio at one nurse to four patients. National Nurses United recommends an even lower ratio of one to three. The Texas Board of Nursing has no au- thority over staffing ratios, calling the issue a “workplace/employment matter,” which is true under state law. Since 2009, Texas re- quires hospitals to implement and enforce written nurse staffing policies to “ensure ad- equate numbers of nurses with skill levels to meet the level of patient care,” leaving it up to hospitals to decided what that means. The Texas Center for Workplace Studies estimates that by 2032 the state will need 291,872 more nurses than the 400,000 working here as of 2021. Based on current employment trends, the state could fall short of meeting that demand by about 57,000 nurses. According to this year’s re- tention and staffing report by NSI Nursing Solutions, for the first time ever the national turnover rate for RNs, meaning the rate at which employees leave their organization, exceeded the overall hospital staffing turn- over rate, jumping up by 8.4% over 2021 to a 27.1% average. Risoldi looks at the problem a little dif- ferently. “We don’t have a nursing shortage,” she said. “We have nurses that are tired of being treated terribly.” ▼ CRIME DEADLY DEAL Courtesy of Sandra Risoldi Unfair Park from p4 can be undone. But the repetitive nature of trauma in this job doesn’t leave room for the kind of break needed to heal. “When you’re surrounded by that trauma for a long time, it’s hard to break out,” Risoldi said. “It almost becomes like an addiction. The addiction of the nurse wanting to take care of this patient to make sure they live. … It’s like you’re molded to make sure the patient is number one, and you’re always the sacrificial lamb.” An emergency room nurse at a Galveston County for-profit hospital, who agreed to speak on the condition of anonymity for fear of workplace retaliation, was one of many nurses who had just started school when COVID hit, launching her from the class- room to the hospital floor. The upstairs units of her hospital have lost a significant portion of the nursing staff, resulting in patients who should be admitted staying in ER beds for upwards of 24 hours. With a full staff, the Galveston nurse’s ER should have six nurses on the floor, but it’s currently down to four. On a rare slow night, her supervisors 6 wanted to send her home, but she chose to stay to support the only other two nurses, she recalled. Within 15 minutes, three vehi- cle accident victims arrived, one of whom, the nurse said, “was a severe trauma that we had to fight hard to keep alive.” Ideally, it should’ve been all-hands on deck for that patient, but it was only one nurse and the trauma surgeon. “The surgeon was literally helping me hang blood because he was the only set of hands available as we worked on this ac- tively dying patient,” she said. “That’s not something he should have ever had to do, but we didn’t have the people we needed.” She feels more confident in her skills now a year into the job but is “exhausted by the needless obstacles placed in our way.” On typical busy nights at the Galveston hospital, when there might only be one bed available, the ER nurse said her team isn’t al- lowed to go on saturation, meaning they can’t tell emergency medical services not to arrive with more patients unless they abso- lutely must. The decision isn’t up to her or her team. It belongs to executives who’ve never worked an ER shift. “Those things cost them money,” she said, “and our mental health is much easier to spend.” lll Kidd, the HCA house supervisor, says his facility is holding its own right now, but called staffing the ER “just a crapshoot” amid a major loss of staff to travel nursing agencies. He defended the current staffing ratio at the hospital of one nurse for every six patients as a standard. But there are no legally defined nurse-to-patient ratios in any state but California, which set the ER I JOSE CARRETO WILL SPEND THE NEXT 30 YEARS IN A FEDERAL PRISON FOR SUPPLYING THE HEROIN THAT LED TO A MINOR’S OVERDOSE. BY PATRICK STRICKLAND t all started a little more than two years ago after a minor nearly died from a heroin overdose, and it last week with a 30-year sentence in a federal prison for supplying the heroin that eventually led to the medical emergency. Last Thursday, U.S. Judge Sean D. Jordan in the Northern District of Texas sentenced Jose Antonio Carreto, a 31-year-old man from Dallas, to three decades behind bars, according to court documents. In March, Carreto’s brother, Isauro Car- reto-Cruz, received a 78-month prison for his part in the drug dealing scheme. Heroin is involved in around 20% of all opioid-related deaths, according to the CDC. In June 2021, a jury convicted both brothers of conspiracy and distribution of heroin resulting in seriously bodily injury, conspiracy to possess with intent to distrib- ute and distribution of methamphetamine, and possession with intent to distribute and distribution of heroin resulting in serious bodily injury aiding and abetting. The minor’s name isn’t listed in court documents, but they survived after being administered a dose of Narcan, a medicine used in emergency situations to reverse the effects of opioid overdoses. After the inci- dent, the minor cooperated with authorities. Once the Plano Police Department, the Texas Department of Public Safety and the Drug Enforcement Administration launched an investigation, they tracked down the immediate supplier, a 21-year-old Plano resident named Kolton Watson. From there, they identified Watson’s suppliers, Carreto and Caretto-Cruz. A Plano police officer stopped the brothers while they were driving and found heroin and methamphetamines in the vehicle. At one point, the Plano Police Department received an anonymous tip that the brothers had arranged a drive-by shooting to kill the minor, the Plano Star Courier reported in June 2021. In a press release, U.S. Attorney Brit Featherston said the case “highlights the dangers of illegal drug use.” Featherstone added, “We are seeing a drastic increase in illegal drugs poisoned with illegal fentanyl that are causing many deaths around the country. We will take all action within our power to investigate and prosecute those who spread this poison in our communities.” In 2020, the number of heroin-related deaths around the country topped 13,000, according to the Centers for Disease Control and Prevention (CDC). That number was 7% lower than the year before, but it still marked a sevenfold increase when compared with 1999. The CDC reported that one in five opioid-related deaths in 2020 involved heroin. Earlier this year, the CDC released preliminary data showing that at least 4,813 people had died of drug overdoses last year in Texas, a 15.9% increase when >> p8 Shutterstock 3 dallasobserver.com | CONTENTS | UNFAIR PARK | SCHUTZE | FEATURE | NIGHT+DAY | CULTURE | MOVIES | DISH | MUSIC | CLASSIFIED | DALLAS OBSERVER MONTH XX–MONTH XX, 2014 OCTOBER 20-26, 2022 DALLAS OBSERVER CLASSIFIED | MUSIC | DISH | CULTURE | UNFAIR PARK | CONTENTS dallasobserver.com
