Dire situation with nursing shortages now…and the numbers ramping up.
The American Hospital Association’s vice president of quality and patient safety, Nancy Foster, said she’s heard from two dozen hospital leaders over the past two weeks, warning her of staffing shortages in states including Texas, North and South Dakota, Minnesota, Wisconsin, and Illinois. Health care providers in Kansas, Oklahoma, Arkansas, Ohio, Missouri, Michigan, and Utah said they’re facing the same problem, as do local reports from New Mexico, Nebraska, Colorado, Wyoming, Tennessee, Georgia, Alabama, Indiana, Montana, California, Rhode Island, and South Carolina.
The shortages are primarily caused by overwhelming numbers of patients as coronavirus spreads, combined with decreasing staff levels as nurses and doctors themselves fall sick or have to quarantine after being exposed to infected people. Covid-19 is also prevalent in rural areas that have been struggling with a shortage of health professionals for years; hospitals in more remote regions don’t have equipment such as ventilators, and so must transfer severely ill patients to already-overwhelmed urban health care systems. The scale of the problem makes it harder to address: Systems designed to offset shortages by bringing in backup from other areas don’t work when so many states are affected simultaneously.
The lack of staff reflects the dramatic increase in patients. There has been an average of 157,318 new cases per day over the past week, according to the STAT Covid-19 Tracker — 74% more than two weeks ago — and there simply aren’t enough ICU nurses, in particular, to meet the need. Hospitals currently have 2,000 ICU nurse jobs open on Trusted Health, a company that connects travel nurses, who hop from job to job around the country, with hospitals.
The situation is exacerbated as staff get sick with coronavirus themselves, or else have to quarantine after exposure. The staffing need is so dire, hospital workers who have tested positive for Covid-19 but are asymptomatic have been told to continue working in North Dakota.
One rural hospital in Texas is struggling with 30% of staff nurses out of commission because of infection with or exposure to Covid-19, said TORCH’s Henderson. At one point earlier this month, more than 1,000 staff from the Mayo Clinic were out of work because of Covid-19, said Amy Williams, executive dean of Mayo Clinic Practice.
“It could be caring for a family member who has Covid, it could be on quarantine because of being exposed in the community, or it could be because the staff member actually has Covid,” Williams said. More than 90% of possible exposures occurred in the community as transmission picked up, she said, not in the hospital.
As health care systems compete for additional staff, salaries skyrocket. ICU nurses are a “hot commodity,” said Dan Weberg, a former emergency room nurse and head of clinical innovation at Trusted Health, and their fees are currently twice as much as pre-Covid rates, at around $5,000 to $6,000 per week.
“This is how PPE was in the beginning of the pandemic. When you’re competing with everyone else in town, and state, and the country, that creates a market that’s not sustainable,” said SSM Health’s Garza.