Why Another COVID-19 Surge Could Devastate U.S. Hospitals

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Through the worst months of the pandemic, intensive care nurse Scott Brickner would sit by COVID-19 sufferers as they took their final breaths.  “I by no means permit a affected person of mine to die alone. Ever,” says Brickner, who works at a big college hospital in Los Angeles. 

Brickner witnessed dying day by day within the surge that started in November 2020. Most of his sufferers have been positioned on ventilators, and few improved. “The laborious half wasn’t essentially simply dying — dying would have been a respite for a few of these sufferers,” he says. ”As an alternative, you have been watching these sufferers cycle by way of a horrible factor.

His division sometimes handled 30 sufferers concurrently pre-pandemic, however he noticed as many as 80 through the rise in instances. Brickner says he felt exhausted and defeated. He describes a four-month interval during which his office felt like a battle zone.  

Like many nurses, Brickner doesn’t know if he may deal with one other COVID-19 surge. Amid the spring 2021 soar in hospitalizations, 30 % of well being care staff mentioned they thought-about leaving the career, in keeping with a ballot by the Washington Put up and the Kaiser Household Basis. 

Though many hospitals have publicized their plans in case of one other main wave, staffing points may disrupt these care plans.  

For one, workers are nonetheless recovering from unprecedented stress. Greater than half of ICU and ER nurses say they’re “emotionally unhealthy,” in keeping with a brand new examine by the American Nurses Basis. Actually, over a 3rd of 26,174 well being care staff surveyed this previous March and April reported PTSD signs, in keeping with a CDC report.

Now, trade leaders fear pandemic-induced trauma will worsen staffing shortages. On September 1, the American Nurses Affiliation despatched a letter to the top of Well being & Human Companies and requested the federal division to deal with the scarcity by, for instance, working to extend salaries. 

Florida emerged from its newest surge in mid-September, and the state’s staffing disaster stays important. Round seventy % of hospitals report they’ll encounter a staffing scarcity throughout the subsequent week, in keeping with the Florida Hospital Affiliation.  

“Each hospital has a surge plan, whether or not that’s due to pandemic or, as a result of we’re in Florida, hurricanes or pure disasters. So all of us have surge plans that permit our hospitals to surge their capability as wanted,” says Marc Lotter, who serves as senior vice chairman of communications, advertising and schooling on the Florida Hospital Affiliation.   

When hospitals develop intensive care items, they achieve this by changing different areas. Nurses and physicians who usually work in different departments are then tapped to offer ICU care. However in hospitals with broader staffing shortages, momentary nurses are employed to fill the hole. “In some instances you usher in contracted workers, like nurses, from momentary staffing businesses at a really, very excessive value,” Lotter says.  

Nonetheless, that is nothing new: Staffing businesses have been filling employment gaps for years. Previous to the pandemic, research estimated the stress of nursing induced turnover charges as excessive as 37 % in some components of the nation. 

Nurses have additionally needed to work additional time to make sure surge protection: Brickner says he labored 16-hour days through the pandemic and often totaled 60 hours per week. His hospital tried to assist workers by ordering pizza for lunch or selling free counseling classes. A donor even equipped therapeutic massage chairs for the break room. However Brickner says he didn’t even have time for any of the morale boosters.  

What’s extra, most nurses report that they don’t really feel supported by their hospital administration. Sixty-seven % of surveyed nurses mentioned their administration didn’t prioritize nurses’ psychological well-being, in keeping with a March 2021 report by Trusted Well being. And 27 % mentioned their administration claimed to prioritize psychological wellbeing however didn’t work to make these initiatives actually efficient.

With out office help, Brickner says he’s been compelled to discover a therapist on his personal and hopes different nurses do the identical. But remedy cannot absolutely tackle the broader systemic chaos. “It’s actually beating us down. I feel there can be a mass exodus of nurses,” he says.  “If we proceed or proceed down this path, if now we have a surge once more, I don’t know if I can maintain being a nurse.” 

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