Amid the COVID-19 rush, hospitals are seeking temporary nurses to fill the care gap
As the United States adds one new coronavirus case every second, hospitals from West Texas to Wisconsin are overwhelmed with the growing number of critically ill Americans.
In many cases, managers are not worried about a shortage of hospital beds, treatments, or equipmentAmid the death toll, with more than 229,000 deaths from COVID-19 in the United States, overworked and overstretched hospital staff need to take care of those in need of life-saving treatments.
The head of the Utah Hospital Association this week warned that the situation is getting so bad that hospitals may soon need to ration care. Hospitals in North and South Dakota are seeking reinforcements for staff to care for patients in crowded intensive care units. And in Wisconsin, hospitals are opening makeshift ICU wards even as they search hard Other nurses and doctors to hire facilities.
“We can continue to transform the ICU space,” said Jeffrey Bothoff, an emergency room physician in Madison, Wisconsin. “But the limitation is going to be employment … that’s the thing that worries us most at the moment.”
More than 536,000 Americans tested positive for coronavirus during the 7-day period ending Thursday, a new record for one week. Another 46,000 have been hospitalized as of Thursday. And perhaps most disturbing is that the proportion of positive cases is increasing in 41 states – an indication that cases are on the rise.
The worsening outbreak, fueled by the stress of Americans with the Coronavirus and the wearing of inconsistent masks and spacing, means hospitals need more doctors, nurses and therapists to fill their shifts. Not only do hospitals need additional workers to cope with the increase, but they also need to replace shifts when their staff get sick or under quarantine.
But with the virus accelerating in many states at the same time, hospitals across the country are taking advantage of the same limited pool of travel nurses, therapists and other doctors who sign contracts to fill work shifts on a temporary basis.
Rising cases in Phoenix, Arizona, in June and July made the nation’s fifth-largest city the epicenter of a summer wave that spread to other states in the Sun Belt. As cases were largely under control elsewhere, Arizona hired travel nurses and respiratory therapists out of the state to temporarily fill shifts in crowded ICUs.
With contract workers working alongside full-time employees, Arizona hospitals averted the initial deadly boom that overwhelmed New York hospitals during the early days of the pandemic.
Banner Health, the largest health system in Arizona, employed more than 1,000 contracted respiratory nurses and therapists from June through mid-July. Without these additional trained workers, the hospital might have used similar measures that Utah hospitals are now studying – legalizing care.
Banner Health CEO Peter Vine worries that hospitals cannot count on temporary employees again.
“The real problem is employee burnout,” Vine said. “It’s a very real phenomenon and with the disease spreading across the country, we can no longer rely on contracted personnel to save us.”
More jobs than we can fill
Recruitment agencies that put travel nurses in hospitals and clinics say they weren’t busy before. In the past four weeks, RN Network, part of CHG Healthcare in Salt Lake City, has filed a 130% increase in job applications, spokesperson Chad Sally said.
Hospitals in nearly every state hire contract nurses to fill their shifts. And those pandemic-driven jobs often pay “crisis rates” that increase compensation 20 to 30% above normal rates, especially for in-demand jobs such as experienced nurses in the ICU.
Sally said that even full-time nurses are leaving their hospital jobs to do lucrative business with travel companies. They can earn extra pay and look forward to adventure without the long-term commitment to a staff position.
“There are a lot more jobs than we can fill ourselves,” said Sally.
Host Healthcare, a healthcare recruitment agency based in La Jolla, California, said requests from hospitals have doubled from last year.
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Not only do hospitals need to hire workers to take care of the sickest patients, some are seeing demand in other areas of the hospital. Hospitals stopped non-emergency operations during the first weeks of the epidemic. When those elective surgeries resumed as states relaxed restrictions, hospitals needed more workers.
In addition to ICU functions, the host fills positions in the Medical, Surgical, Post-operative Recovery and Telemetry units to remotely monitor patients’ vital signs.
All of these additional demands mean that travel nurses can be paid higher wages. Travelers can earn in five to six months what a nurse does in a year, according to Gerald Cohen, CEO of Training and Development at Hosts.
“I’ve never seen a request like this,” Cohen said.
Staff limits patient care
In North Dakota, where the per capita COVID-19 cases are among the highest in the country, the state directed $ 10 million in federal funds to the six largest hospital systems in the state. The purpose: to help hospitals that must pay lucrative travel nursing fees, in addition to other recruitment expenses, said Tim Blassel, president of the North Dakota Hospital Association.
Nearly one in five North Dakota hospital patients has COVID-19, the largest proportion of these patients in the country. South Dakota has the second highest proportion of hospitalized coronavirus patients, followed by Montana and Wisconsin, according to data from the US Department of Health and Human Services.
As North Dakota was among the first states to experience the current surge, it mobilized hospitals early to hire travel nurses, therapists, and other contact workers. The current hospital staff took extra shifts and worked long hours to keep up with the demands.
This early jump in hiring contract workers means the country may have an advantage in securing an adequate workforce, Blasel said.
However, travelers have options, and will the harsh winter conditions in the High Plains states force nurses and doctors to seek out other states?
“We are competing with other hospitals, other states, in terms of personnel. It’s too expensive,” Blassel said. “When you enter winter, will it get more difficult? It’s possible. We are spending a lot of dollars on contracted labor. It might not be different from other hospitals across the country.”
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Hospitals in Wisconsin are struggling to keep up with the increase in cases there. The state has opened a field hospital near Milwaukee to deal with the excess cases.
Bothoff, an assistant professor of emergency medicine at the University of Wisconsin School of Medicine and Public Health and chief quality officer at UW Health in Madison, said his hospital was seeking to deal with a growing number of patients. He said that one in three Covid-19 patients admitted to hospital was “very sick” and required intensive care unit (ICU) care.
The hospital plans to open a new ICU in November, but as cases increase, the hospital has started moving patients to the new unit this week. Another medical unit has been converted into an intensive care space.
In addition to space and equipment, these units need workers. A nurse in a regular intensive care unit can take care of two patients, but sickest Covid-19 patients need round-the-clock attention. Some of them are related to cardiopulmonary bypass devices and must be monitored constantly, so there is one nurse for every patient in the ICU who has coronavirus.
The hospital contacted travel nursing agencies and also researched their ranks. Some of the nurses who work in the outpatient clinics have experience in the hospital and can hold some shifts.
However, finding ICU nurses and other health workers limits the number of critically ill patients the hospital can handle.
“Every nurse who wants a job right now in the United States has a job,” Bothoff said. “Employment is what keeps me awake at night.”
The growing emergency: El Paso County is ordering a two-week lockdown amid the COVID-19 surge
In El Paso, Texas, a judge sought to force the community by ordering a two-week shutdown of non-essential businesses. City hospitals are stretched to capacity and medical personnel are overwhelmed as the province grapples with a record number of cases.
Infectious disease experts say the ongoing pressure of new cases and the overwhelmed hospital staff marks a new phase of the epidemic. Unlike the days before COVID-19, fewer hospitals will be able to receive referrals for patients from hard-hit communities.
“It’s something more prevalent than the outbreaks that occurred in the Sunbelt ring in the summer or in the northeast in the spring,” said Dr. Amish Adalja, a senior researcher at the Johns Hopkins Center for Health Security. “This only underscores the need to control this virus.”
Ken Alltucker is on Twitter as kalltucker or can be emailed at [email protected]
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