My name is Jenna, and I am a Hospitalist at Essentia Health in Duluth.
I first experienced Duluth as a 20-year-old college student visiting with my mom to run the Garry Bjorklund half marathon. I thought it was a beautiful and intriguing place. At that time I was in school in Madison, WI and still figuring out my path in life. A few years later I was a physician assistant (PA) student at Duke in Durham, NC. I had pivotal student rotation experiences—I took care of all ages, I saw discrepancies in care and facilities on different sides of town and the state, I saw life born and touched the hands of life passing away. I spent time in Ecuador learning from dóctoras practicing in the Andes, often on foot, with no running water or electricity. And at the end of my studies, the Duluth area called me back!
In 2014 I signed on with Essentia Health as a newly minted PA to work as a hospitalist—meaning I manage the care of hospitalized adults. Patients find their way to our hospitals from across Minnesota and Wisconsin (and beyond), and the Advanced Practice Providers (APPs) on our team—nurse practitioners and physician assistants—also travel to or permanently staff our community hospitals in Sandstone, Aurora, Deer River, and Virginia. Once patients are well enough to discharge, I turn their care back over to their clinic providers, who are often my other APP colleagues throughout the Essentia system. Over the last 11 years, I have gotten to know many of them not only as colleagues, but as neighbors. We are your soccer moms, food shelf volunteers, and Grandma’s marathon medical staffers. Some of us are veterans. Some of us hold elected positions locally. We have grown roots in the community and our care goes beyond the walls of our hospitals and clinics.
But increasingly, we are feeling powerless in our practice—and it is affecting our patients and communities too. We are constantly asked to do more with less. We are getting less face-to-face time with our patients. Our duties and hours are ever expanding. And when some of us would like to serve unmet needs of our patients and provide care, volunteer or otherwise, at non-Essentia community health clinics, we are often barred from doing so by restrictive noncompete contracts that Essentia continues to enforce. These aren’t just technicalities—they are policies that prevent APPs from filling the gaps where patients most need us.
These decisions are often made by administrators unfamiliar with our practice or patient needs, who may not live near our communities. When we feel pressured that the bottom line matters more than the human in our care, we experience moral injury—a progressive distress where our moral compass conflicts with the systemic limitations being imposed. We have tried to make up for the limitations by sacrificing our personal time—staying late, taking on special projects despite inadequate support, and taking work home. But this comes at a cost. It is eating away at our resilience, straining our families and our ability to keep serving our communities. Each year I see more of my APP colleagues, who have served their patients faithfully for years, move on from positions due to frustration and burnout. And when experienced providers leave, it’s our patients and communities who feel the loss.
Community members—we desperately need your support in keeping Essentia accountable. Our concerns and APP voices have been dismissed for too long. Our communities need us to stay rooted, resilient, and practicing in a way that truly makes a healthy difference for all of us. We need our communities to stand with us, to remind Essentia that patients must come first, and that healthcare workers deserve the time and respect it takes to care for our neighbors well. Please stand with us and demand Essentia do what’s right for patients by doing right by the providers delivering care.
We live here too. We love these communities. And we want to keep caring for them for years to come.