NURSE RANKS growing thin in face of new wave of cases.
Bedside health workers, smaller hospitals face increased stress with variant
As the highly contagious delta variant pummels the United States, bedside nurses, the workhorses of a welloiled hospital, are depleted and traumatized, their ranks thinned by early retirements or career shifts that traded the emergency room for less stressful nursing jobs at schools, summer camps and private doctors’ offices.
“We’re exhausted, both physically and emotionally,” Cyndy O’Brien, an emergency room nurse in Mississippi, said, choking back tears.
Nursing shortages have long vexed hospitals. But in the year and a half since its ferocious debut in the U.S., the pandemic has stretched the nation’s nurses as never before, testing their skills and stamina as desperately ill patients with a poorly understood malady flooded emergency rooms. They remained steadfast amid a calamitous shortage of personal protective equipment; spurred by a sense of duty, they flocked from across the country to the newest hot zones, sometimes working as volunteers. More than 1,200 of them have died from the virus.
O’Brien could not believe her eyes as she arrived for work at Ocean Springs Hospital on Mississippi’s Gulf Coast. There were people sprawled out in their cars gasping for air as three ambulances with gravely ill patients idled in the parking lot. Just inside the front doors, a crush of anxious people jostled to get the attention of an overwhelmed triage nurse.
“It’s like a war zone,” said O’Brien, who is the patient care coordinator at Singing River, a small health system near the Alabama border that includes Ocean Springs. “We are just barraged with patients and have nowhere to put them.”
The bottleneck, however, has little to do with a lack of space. Nearly 30% of Singing River’s 500 beds are empty. With 169 unfilled nursing positions, administrators must keep the beds empty.
Like hospital leaders across much of the South, Lee Bond, chief executive of Singing River, has been struggling to stanch the loss of nurses over the past year. Burnout and poaching by financially flush health systems have hobbled hospitals during the worst public-health crisis in living memory.
Bond is terrified things will worsen in the coming weeks as schools reopen and Gov. Tate Reeves doubles down on his refusal to reinstate mask mandates. “Our nurses are at their wits’ end,” Bond said. “They are tired, overburdened, and they feel like forgotten soldiers.”
According to an analysis by The New York Times, 1 in 5 ICUs are at least 95% capacity — a level experts say makes it difficult to maintain standards of care for the very sick.
“When hospitals are understaffed, people die,” said Patrica Pittman, director of the Health Workforce Research Center at George Washington University.
In Mississippi, where coronavirus cases have doubled over the past two weeks, health officials are warning that the state’s hospital system is on the verge of collapse. The state has 2,000 fewer registered nurses than it did at the beginning of the year, according to the Mississippi Hospital Association. With neighboring states also in crisis and unable to take patient transfers, the University of Mississippi Medical Center in Jackson, the only Level 1 trauma unit in the state, has been setting up beds inside a parking garage.
“You want to be there in someone’s moment of need, but when you are in disaster mode and trying to keep your finger on the leak in the dike, you can’t give every patient the care they deserve,” said Dr. LouAnn Woodward, the medical center’s top executive. With staffing shortfalls plaguing hospitals coast to coast, bidding wars have pushed salaries for travel nurses to stratospheric levels, depleting staff at hospitals that cannot afford to compete. Many are in states flooded with coronavirus patients.
Texas Emergency Hospital, a small health system near Houston that employs 150 nurses and has 50 unfilled shifts each week, has been losing experienced nurses to recruiters who offer $20,000 signing bonuses and $140-anhour wages. Texas Emergency, by contrast, pays its nurses $43 an hour with a $2 stipend for those on the night shift. “That’s ridiculous money, which gives you a sense of how desperate everyone is,” said Patti Foster, the chief operations officer of the system.
Foster sighed when asked whether the hospital offered signing bonuses. The best she can do is pass out goody bags filled with gum, bottled water and a letter of appreciation that includes online resources for those overwhelmed by the stress of the past few weeks.