Exhausted staffs, surging COVID-19 cases push nation’s limits

As the United States adds a new coronavirus case every second, hospitals from West Texas to Wisconsin are overwhelmed with the soaring number of critically ill Americans.

In many cases, it’s not a lack of hospital beds, therapies or equipment that worry managers amid the surge, with more than 229,000 deaths from COVID-19 in the U.S. It’s the depleted and exhausted hospitals staffs needed to care for those who need life-sustaining therapies.    

The head of the Utah Hospital Association this week warned the situation is getting so dire hospitals there might soon need to ration care. Hospitals in North and South Dakota are seeking staff reinforcements to care for patients in crowded intensive care units. And in Wisconsin, hospitals are opening makeshift ICU wings even as they desperately look for nurses and other clinicians to staff the facilities.

“We can keep converting ICU space,” said Jeffrey Pothof, an emergency room doctor in Madison, Wisconsin. “But the constraint will be the staffing … that’s the thing that worries us the most right now.”

More than 536,000 Americans tested positive for coronavirus over a 7-day period ending Thursday, a new one-week record. Another 46,000-plus were hospitalized as of Thursday. And perhaps more troubling, the share of positive cases is increasing in 41 states – a sign cases are on the upswing.

The worsening outbreak, fueled by Americans’ coronavirus fatigue and inconsistent mask wearing and distancing, means hospitals need more doctors, nurses and therapists to fill shifts. Not only do hospitals need extra workers to handle the surge, they also need to replace shifts when their own staffers are sick or quarantined.

But with the virus accelerating in so many states at the same time, hospitals nationwide are tapping the same limited pool of travel nurses, therapists and other clinicians who sign contracts to fill 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 surge that spilled over to other Sunbelt states. Because cases were largely under control elsewhere, Arizona recruited out-of-state travel nurses and respiratory therapists to temporarily fill shifts in crowded ICU units

With contract workers working side by side with full-time staffers, Arizona hospitals averted the deadly initial surge that overwhelmed New York hospitals during the early days of the pandemic.

Banner Health, Arizona’s largest health system, recruited more than 1,000 contract nurses and respiratory therapists from June through mid-July. Without those extra trained workers, the hospital might have used similar measures that Utah hospitals are now considering – rationing care.

Banner Health CEO Peter Fine worries hospitals can’t depend on stopgap staffing again.

“The real issue is staff burnout,” Fine said. “It’s a very real phenomenon and with a countrywide breakout we no longer can count on contracted staff to save us.”

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