Could Memphis see nurse shortage soon?

Hospitalized COVID-19 patients rise in Shelby County

As the number of hospitalized COVID-19 patients continues to rise in Shelby County, local officials said it is becoming increasingly likely that hospital surge capacity will have to be tapped — requiring more doctors, nurses, respiratory therapists and other medical personnel to staff the extra beds brought online.

As of 5 p.m. Monday, there were 342 hospitalized COVID-19 patients in Shelby County and the seven-day average. The number of hospitalized patients has been increasing for the past two weeks. The resumption of elective procedures has also led to an increase in the number of hospitalized patients in both acute and intensive care unit beds.

The Memphis area’s hospital systems have all had surge plans in place for months, including how to increase staffing as needed. But, amid a prolonged, nationwide shortage of nurses, the question remains of whether there are enough nurses — who often spend the most time with hospitalized patients — to staff the

additional beds.

Local medical professionals and officials have not outright said that there are not enough nurses to handle a surge, but they have said it is a concern. Shelby County Health Department Director Alisa Haushalter said last week that the continued rise in hospitalizations could strain the current number of available nurses.

“There is some concern that the hospitals (are) being stretched, and that would be in staffing as well,” she said. “We have a nursing shortage across the United States, so this is not a problem that’s germane just to Shelby County. But having sufficient staffing is always a challenge.”

A 2012 article published in the American Journal of Medical Quality projected a shortage of registered nurses would persist nationwide until 2030 and that the most severe shortages would be in the South and the West. A Georgetown study estimated a shortage of 200,000 registered nurses and licensed practical nurses in 2020.

The county has 2,635 acute care beds and 479 intensive care unit beds at this time. If there is a surge, each hospital has the capability to expand bed capacity internally, adding hundreds more before the 400-bed hospital constructed inside the former Commercial Appeal building would be utilized.

Volunteer medical personnel

Early on in the pandemic, local public health and government officials foresaw a need for additional essential workers, including medical professionals, and put out a call for volunteers.

As of Friday, there were 1,797 registered volunteers for the Memphis Medical Reserve Corps — 542 medical personnel and 1,255 non-medical personnel, according to Shelby County Health Department public information officer Joan Carr. Many of the medical personnel who have volunteered are nurses, the health department said previously.

The department has said those volunteers, who will be paid if they are called in to work in hospitals, would patch staffing gaps at hospitals due to personnel getting sick or needing a rest.

Dr. Steve Threlkeld, co-chair of the infection control program at Baptist Memorial Hospital-memphis, said there were 82 hospitalized COVID-19 patients on Monday — the highest number of patients the hospital has seen at one time since the beginning of the pandemic.

Baptist, like other Memphis-area hospitals, has the capability to quickly increase the number of acute care and ICU beds within its walls. But the beds are only as good as the medical personnel who staff them.

“There are plenty of places to open up beds, but you need to have the staff to do it,” Threlkeld said. “Particularly nursing staff can be a challenge at any point, at any time these days.”

While the hospital has surge plans in place, including how to secure additional nurses, he said the root of the problem was that “we need to blunt the curve again.” Officials in Memphis were able to see the impact the virus had in other communities and prepare, he said, but even well-prepared communities can be overwhelmed by the pandemic.

“We don’t need to drop the ball on that advantage we’ve been given,” Threlkeld said.

He said that while a high percentage of hospital beds — for all patients, not just those with COVID-19 — were occupied at Baptist, that was not unusual, given the resumption of elective procedures. However, he said those occupancy rates could become more concerning in the winter months when there are typically higher numbers of people being hospitalized overall.

NON-COVID-19 critical patients increase

Methodist Le Bonheur Healthcare spokesperson Rachel Powers said as of July 1, Methodist had 1,313 beds systemwide and 294 ICU beds — excluding obstetrics, the nursery and the NICU. At that time, 84% of those ICU beds were occupied, but only 17% of those were COVID-19 patients. The vast majority of ICU patients were hospitalized for other reasons.

“We are seeing more patients in need of critical care in our hospitals and emergency departments because they are coming in with more advanced disease progression, which requires more advanced and complicated care,” she said. “We strongly urge individuals not to delay doctor’s visits or screenings. Do not ignore symptoms. Go to an emergency room if you have an urgent medical need.”

Powers said the system has prepared for a surge, including how to increase the number of beds and adjust staffing to cover them all. The number of personnel needed to staff each of those beds varies based on the needs of the patient, she said.

Lost revenue due to canceled elective procedures forced Methodist to make some staffing reductions this spring, including voluntary and non-voluntary furloughs and reduced hours. Powers said these policies did not impact the quality of patient care at the system’s hospitals.

Shelly Weiss Friedberg, director of public relations for Tenet Healthcare, which owns Saint Francis, said staffing levels were “appropriate,” adding that staffing in some departments had been increased to take care of current COVID-19 patients and prepare for a surge.

“Other units and services were closed or ramped down due to state orders, and while most have reopened, we have adjusted our staffing to meet the current needs,” she said.

Regional One Health spokesperson Angie Golding said the hospital has not furloughed any employees but that some are working on reduced hours. The number of beds staffed in the hospital varies with patient loads and the number of staff needed at each bed varies with the needs of the patient, she said.

Corinne Kennedy is a reporter for the Commercial Appeal. She can be reached via email at Corinne.kennedy@ Commercialappeal.com or on Twitter @Corinneskennedy

JOE RONDONE/THE COMMERCIAL APPEAL Nurse Whitney Jones works in the cardiac transplant step-down unit, an area Baptist Memorial Hospital-memphis could utilize as a converted space for COVID-19 patients should the need arise.

MAX GERSH/ THE COMMERCIAL APPEAL Registered nurse Dorothy Kabatu (right) puts on personal protective equipment while transporter Sherrika Hamilton moves a wheelchair into place to discharge a COVID-19 patient on June 25 at Methodist North Hospital in Memphis.

JOE RONDONE/THE COMMERCIAL APPEAL Nurse Meaghan Hohe, left, leads a discussion with the intensive care unit staff at Baptist Memorial Hospital-memphis on May 14. Dr. Steve Threlkeld, co-chair of the hospital’s infection control program, said there were 82 hospitalized COVID-19 patients at the hospital on Monday.