When hospitals are filled with COVID-19 patients, it becomes difficult to find medical reinforcements-NPR News

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Many hospitals in the country are trying to deal with an unprecedented number of COVID-19 patients. As of Sunday 93,238 Hospitalization was a staggering record of just under 60,000 inpatients, well above the last two peaks in April and July.

But beds and spaces are not the main concern. It’s a labor force. Hospitals are worried that the level of staff will not keep up with demand as doctors, nurses, respiratory therapists and other professionals become exhausted and, worse, infected and ill.

Even though the initial surge in cases helped ease the initial tensions of a pandemic concentrated in a few “hotspot” cities, the typical workaround for staff shortages (hiring clinicians from outside the town) is no longer Not a solution like New York, Detroit, Seattle, New Orleans.

It was also easy in the spring to recruit those temporary reinforcements as there were actually hospitals outside the first hotspot. Small number of patients Than usual Mass dismissal.. In short, many nurses were excited to be able to fly to another city. Help with treatment At the forefront.

Often the hospital Forced to compete For travel nurses, the payment rate for temporary nurses has skyrocketed. In April, Vanderbilt University Medical Center in Nashville Raise wages Of the fewer staff nurses than the newly arrived temporary nurses.

In the spring, a nurse who answered a phone call from a needy “hotspot” hospital could not order a high salary.Some too talked How meaningful and satisfying the job was, trying to save lives in a historic pandemic, or Existing For families who couldn’t visit their sick or dying loved ones.

“It was a really hot zone, and we were always in full PPE and everyone admitted was COVID positive,” said Laura in Knoxville, Tennessee, who helped launch Ryan Larkin Field Hospital in New York City. Williams says.

“I worked six or seven days a week and I’m very well.”

After two months of taxation, Williams returned to nursing in June. University of Tennessee Medical Center.. For some time, the COVID front remained relatively quiet in Knoxville. But then a surge in autumn struck: Record hospitalization Increasing almost every day in Tennessee 60% last month.

Health officials report that finding a backup clinician is much more difficult.

Tennessee is currently building its own field hospital to handle patient overflows. One is inside Memphis’ old commercial appeal newspaper and the other occupies two unused floors at Nashville General Hospital.But if they are needed now, the state Trouble Hospitals are already struggling to place staff in the beds they have, so find doctors and nurses to do them.

“The hospital’s capacity depends almost exclusively on staffing,” said Dr. Lisa Piercy, director of health at Tennessee. “Physical space, physical bed, it doesn’t matter.”

When it comes to staffing, coronaviruses create complex challenges.

When the number of cases reaches new highs, a record number of hospital personnel themselves are temporarily quitting work because they are infected with COVID-19 or have to be quarantined after possible exposure. I have no choice but to do so.

“But here’s the kicker,” says Dr. Alex Jahangil, chair of the Nashville Coronavirus Task Force. “They are not infected in hospitals. In fact, most hospitals are fairly safe. They are infecting the community.”

Some states, such as North Dakota, have already decided to allow COVID-positive nurses to continue working as long as they feel okay, and that move has spawned some. Backlash..Colorado, California, Illinois Asked Retired nurses and doctors consider returning to work.

In Tennessee, Governor Bill Lee Urgent order Relax regulatory restrictions on who can do what in the hospital and increase staff flexibility.

For months, staffing in many parts of the country has been a behind-the-scenes concern. But that is becoming apparent to every patient.

Dr. Jessica Rosen, an emergency physician at St. Thomas Health in Nashville, has had little need to transfer patients to other hospitals for the past decade. She says it’s a common occurrence now.

“We make frequent diversions, which means we don’t receive transfers from other hospitals,” she says. “I’m trying to send an ambulance to another hospital because I don’t have a bed.”

Even the largest hospital in the area is full.This week, Vanderbilt University Medical Center Made a space At that children’s hospital for non-COVID patients. The adult hospital has more than 700 beds. Also, like many hospitals, there was the challenge of staffing in two intensive care units. One is for COVID patients only and the other is for all other patients.

And they come from far away from Arkansas and southwestern Virginia.

“The majority of patients currently in the intensive care unit do not come from the emergency department,” says Dr. Matthew Semler, a VUMC lung specialist who treats COVID patients.

“They have been sent for hours to be in our hospital because all hospitals are bypassing between here and the place presented to the emergency department.”

Semler says his hospital usually brings nurses from outside the town to help. But so far there is no place to pull them out.

Nationwide provider groups are still moving staff, which means more and more leaving a little staff shortage elsewhere. Dr. James Johnson of Nashville-based physician services company Envision has deployed reinforcements to Lubbock and El Paso this month.

The country hasn’t achieved that yet, but he says hospitals have limited capacity.

“Honestly, I don’t know where that limit lies,” he says.

The restrictions at this point are not ventilators or protective equipment. Most often it will be a healthcare professional. The power of people.

Johnson, an Air Force veteran who treated injured soldiers in Afghanistan, says he is more focused than ever on trying to boost doctors’ morale and stop burnout.

He is generally optimistic, especially after four weeks of service in New York City early in the pandemic.

“What we have experienced in New York and what has happened in every episode since then is that humanity stands up on that occasion,” he says.

But Johnson says the sacrifice shouldn’t just come from national health workers. He says that everyone is responsible for keeping themselves and others from getting sick in the first place.

This story is part of NPR’s Health Reporting Partnership. Nashville Public Radio And Kaiser Health News..

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