Hospitals are seeking staffing help as COVID-19 surges.
As the United States adds a new coronavirus case every second, hospitals from West Texas to Wisconsin are overwhelmed with the soaring number of critically ill Americans.
In many cases, it’s not a lack of hospital beds, therapies or equipment that worry managers amid the surge, with more than 229,000 deaths from COVID-19 in the U.S. It’s the depleted and exhausted hospitals staffs needed to care for those who need life-sustaining therapies.
The head of the Utah Hospital Association last week warned the situation is getting so dire that hospitals there might soon need to ration care. Hospitals in North and South Dakota are seeking staff reinforcements to care for patients in crowded intensive care units. And in Wisconsin, hospitals are opening makeshift ICU wings even as they desperately look for nurses and other clinicians to staff the facilities.
“We can keep converting ICU space,” said Jeffrey Pothof, an emergency room doctor in Madison, Wisconsin. “But the constraint will be the staffing ... that’s the thing that worries us the most right now.”
More than 536,000 Americans tested positive for coronavirus over a 7-day period ending Thursday, a new one-week record. Another 46,000-plus were hospitalized as of Thursday. And perhaps more troubling, the share of positive cases is increasing in 41 states – a sign cases are on the upswing.
The worsening outbreak, fueled by Americans’ coronavirus fatigue and inconsistent mask wearing and social distancing, means hospitals need more doctors, nurses and therapists to fill shifts. Not only do hospitals need extra workers to handle the surge, they also need to replace shifts when their own staffers are sick or quarantined.
But with the virus accelerating in so many states at the same time, hospitals nationwide are tapping the same limited pool of travel nurses, therapists and other clinicians who sign contracts to fill shifts on a temporary basis.
Rising cases in Phoenix in June and July made the nation’s fifth-largest city the epicenter of a summer surge that spilled over to other Sunbelt states. Because cases were largely under control elsewhere, Arizona recruited out-ofstate travel nurses and respiratory therapists to temporarily fill shifts in crowded ICU units.
With contract workers working side by side with full-time staffers, Arizona hospitals averted the deadly initial surge that overwhelmed New York hospitals during the early days of the pandemic.
Staffing agencies that place travel nurses in hospitals and clinics say they’ve never been busier. In the past four weeks, RN Network, part of Salt
Lake City-based CHG Healthcare, has fielded a 130% increase in staffing requests, said spokesman Chad Saley.
Hospitals in nearly every state are recruiting contract nurses to fill shifts. And those pandemic-driven jobs often pay “crisis rates” that swell compensation 20% to 30% above normal rates, especially for in-demand jobs like nurses with ICU experience.
Even full-time nurses are leaving hospital jobs to take lucrative gigs with travel companies, Saley said. They can earn extra pay and covet the adventure without the long-term commitment of a staff position.
“There are many more jobs than we could ever fill by ourselves,” Saley said.
In North Dakota, where COVID-19 cases per capita are among the highest in the nation, the state directed $10 million in federal funds to the state’s six largest hospital systems. The purpose: aid hospitals that must pay lucrative travel nursing fees, as well as other staffing expenses, said Tim Blasl, president of the North Dakota Hospital Association.
Nearly one in five patients in North Dakota hospitals has COVID-19, the largest share of such patients in the nation. South Dakota has the second highest share of hospitalized coronavirus patients, followed by Montana and Wisconsin, according to U.S. Department of Health and Human Services data.
Because North Dakota was among the first states hit with the current surge, hospitals mobilized early to hire travel nurses, therapists and other contact workers. Existing hospital staffers took extra shifts and worked long hours to keep up with the demands.
This early jump on hiring contract workers means the state might have an advantage securing enough workforce, Blasl said.
Hospitals in Wisconsin are struggling to keep pace with the surge in cases there. The state opened a field hospital near Milwaukee to handle excess cases.
Pothof, an assistant professor of emergency medicine at the University of Wisconsin School of Medicine and Public Health and chief quality officer at UW Health in Madison, said his hospital is seeking to handle a growing number of sick patients. About one in three COVID-19 patients admitted are “super sick” and need ICU care, he said.
The hospital planned to open a new ICU unit in November, but with cases mounting, the hospital began moving patients to the new unit last week. It also converted another medical unit into ICU space.
Beyond space and equipment, these units need workers. A nurse in a normal ICU unit can take care of two patients, but the sickest COVID-19 patients need round-the-clock attention. Some are hooked to heart and lung bypass machines and must be constantly monitored, so there is one nurse for every ICU patient with COVID.
The hospital has contacted travel nursing agencies and also looked within its own ranks. Some nurses who work in outpatient units have hospital experience and can fill some shifts.
Still, finding ICU nurses and other health workers limits the number of critically ill patients the hospital can handle.
“Pretty much every nurse who wants a job right now in the United States has a job,” Pothof said. “Staffing is the one that keeps me up the most at night.”
“We can keep converting ICU space. But the constraint will be the staffing ... that worries us the most right now.”