Hospitals battle for nurses in pandemic, especially in rural areas

FENTON, MICHIGAN — As the coronavirus pandemic surges across the nation and infections and hospitalizations rise, medical administrators are scrambling to find nursing help — especially in rural areas and at small hospitals.

Nurses are being trained to provide care in fields where they have limited experience. Hospitals are scaling back services to ensure enough staff to handle critically ill patients. And health systems are turning to short-term travel nurses to help fill the gaps.

Adding to the strain, experienced nurses are “burned out with this whole (pandemic)” and some are quitting, said Kevin Fitzpatrick, an emergency room nurse at Hurley Medical Center in Flint, Michigan, where several left just in the past month to work in hospice or home care or at outpatient clinics.

“And replacing them is not easy,” Fitzpatrick said.

As a result, he said, the ER is operating at about five nurses short of its optimal level at any given time, and each one typically cares for four patients as COVID-19 hospitalizations surge anew. Hospital officials did not respond to requests for comment.

But the departures are not surprising, according to experts, considering not only the mental toll but the fact that many nurses trained in acute care are over 50 and at increased risk of complications if they contract COVID-19, while younger nurses often have children or other family to worry about.

“Who can actually work and who feels safe working are limited by family obligations to protect their own health,” said

Karen Donelan, professor of U.S. health policy at Brandeis University's Heller School for Social Policy and Management. “All of those things have been factors.”

Donelan said there is little data on how the pandemic, which has killed more than 236,000 people in the country, is affecting nursing overall. But some hospitals had a shortage even before the virus took hold, despite a national rise in the number of nurses over the past decade.

With total confirmed coronavirus cases surpassing 9.7 million in the U.S. and new daily infections rising in 47 states, the need is only increasing.

Wausau, Wisconsin-based Aspirus Health Care is offering $15,000 signing bonuses for nurses with at least a year of experience and hiring contract nurses through private staffing companies to handle a surge in hospitalizations that prompted the system to almost quadruple the number of beds dedicated to COVID-19 patients.

Aspirus, which operates five hospitals in Wisconsin and four in small communities in Michigan's Upper Peninsula, also is moving nurses around between departments and facilities as hot spots emerge, said Ruth Risley-Gray, senior vice president and chief nursing officer at Aspirus.

Outside help still is needed, in part because some nurses have gotten sick from or were exposed to the coronavirus during the current wave, which “came with a vengeance” starting in August, Risley-Gray said. At one point in mid-October, 215 staffers were in isolation after showing symptoms or being exposed to someone who tested positive, and some are just starting to return to work.

Aspirus recently was able to hire 18 nurses from outside agencies, and may need more if the surge continues.