Strapped by Shortage and Hit With Departures, Nurse Corps Swamped by Another COVID Wave

 An medical care nurse trained in communicable disease treatment, Alexander had spent some two months working marathon shifts in an ICU ward within the San Francisco Bay Area, even as the primary tsunami of COVID-19 patients began. Though she had volunteered, she recalls, the scene was apocalyptic: beds, ventilators, protective gowns, facemasks and even mortuary space were all scarce, but the patients kept coming. and therefore the end was nowhere in view .

 

After yet one more shift within the "meat grinder" that day, Alexander says, "I had a breakdown at work. I started crying, and that i just about couldn't stop. and that i basically didn't stop crying for, like, three or four weeks."

 

Intense psychotherapy helped, but the post-traumatic stress disorder was so severe that "stupid things would trigger me to cry," Alexander says, including a dead houseplant. In chats with colleagues, one question recurred: Why stay during a hard, dangerous, seemingly thankless job?

 

"Nurses are considered one among the foremost trusted professions," Alexander says, but she wasn't feeling the admiration – not after grueling, marathon shifts, scrounging for private protective equipment, and self-isolating reception to guard loved ones from infection. "We were like, 'No, actually, nobody cares if we live or die.' which was really stunning for us."

Alexander's story, while dramatic, isn't unique. The nation's nursing corps – already struggling thanks to a staffing shortage that predates the pandemic – is in crisis now that a fourth wave of COVID-19 cases has crashed into the U.S. health care system.

 

With hospitals within the U.S. again running out of ICU bed space, administrators are handling a shortage of nurses, scrambling to fill shifts and offering high wages to those that can help. the matter comes because the crushing workload of the coronavirus pandemic, including external and on-the-job pressures, have led some nurses to easily step down altogether.

 

Both data and anecdotes confirm that front-line nurses are burned out, uninterested and feeling underappreciated. While the shortage in their field has resulted in hospitals paying top dollar for knowledgeable care, a mass exodus of nurses might be on the horizon.

 

"The bravery and dedication of America's nurses are displayed in front-page newspaper stories across the country throughout the COVID-19 pandemic," consistent with a May review of the nation's nursing shortage published by the University of St. Augustine School for Health Sciences. "However, the pandemic has also been an enormous strain on nurses and therefore the healthcare system."

The converging crises carry significant consequences for patients also as nurses themselves. Research indicates stressed nurses are more likely to form mistakes in caring for patients. Already a profession with a big risk of suicide and drug abuse , experts say the pressure of a once-in-a-century health crisis doesn't help lower those odds.

 

Amy Witkoski Stimpfel, an professor within the Rory Meyers College of Nursing at ny University, says the circumstances are "really demoralizing" for nurses still on the work . Early within the pandemic, many reported worrying about working short-handed and being afraid to travel to figure .

 

"After being on the front lines, and just witnessing the kinds of death that are so, so traumatic and awful, I could certainly see that this is able to be the purpose where people were brooding about getting out of direct patient care, or perhaps brooding about a replacement career altogether," she says.

 

Linda McCauley, dean of the Hodgson Woodruff School of Nursing at Emory University, was more succinct. "I was lecture a chief nursing officer just last week," McCauley recalls, "and she said, 'I just do not know if we've the resiliency to travel through this again.'"

 

A survey of nurses by Vivian, a health care worker marketplace, a year into the pandemic helps illustrate the scope of the matter . Among respondents, 43% were considering quitting, which share rose to just about half among medical care nurses – specialists routinely called on to worry for COVID-19 patients.

 

By comparison, other pandemic surveys have shown that around 20% to 30% of health care workers said they were thinking of leaving.

 

The increased stress on nurses, experts say, is said to many factors. Bedside nurses typically have close contact with patients, putting them in danger of contracting COVID-19. Adding to the pressure and an already-existing shortage: an expected increase of retirements in an aging nursing workforce and an ongoing struggle to balance an important , front-line job with the responsibility of caring for young children or elderly parents.

 

At an equivalent time, the necessity for caregivers across a mess of health care specialties also has run into the system's failure to replenish the workforce, with some 80,000 qualified applications to nursing schools rejected in 2020 "due primarily to a shortage of clinical sites, faculty, and resource constraints," consistent with the American Association of schools of Nursing.

Last year, when the primary wave of COVID-19 patients threatened U.S. hospitals, some sounded the alarm a few looming staffing shortage.

 

"Recent analyses have raised concerns about whether the us has enough hospital capacity for a surge of patients needing look after COVID-19 infections," reads a March 2020 blog post authored by the University of California-San Francisco's Joanne Spetz and published by Health Affairs. "But albeit we will double or triple the amount of medical care unit beds, we do not have enough nurses to staff them."

 

The stress on nurses further intensified when schools pack up last spring: Some undoubtedly were caught between their roles as caregivers during a serious health crisis and fogeys trying to work out what to try to to with kids stuck reception .

 

Women often bear the brunt of kid care and other home responsibilities, and Stimpfel, of NYU, points out that nursing is "still a really female-dominated profession." The highly contagious coronavirus, she adds, made some nurses take drastic steps to guard their families, compounding the difficulties.

 

"We had nurses that were living in hotels and living aside from their children and making additional sacrifices," Stimpfel says. "They weren't only on the front lines, taking care of patients, on the other hand saying, 'I can't head home to my family, i can not see my children, i can not see my partner.'"

 

According to an American Nurses Foundation survey in early 2021, 59% of nurses believed they put their patients' needs before their own. but half respondents agreed that their employer understood their outside responsibilities and offered support or flexibility to assist meet them.

 

Perhaps encouragingly, while 18% of respondents said they planned to go away their position within the next six months – many due to their work's negative impact on their health and well-being – just 4% said they planned to go away the profession entirely.

 

Still, within the 2021 lull after vaccines became available, some nurses quit, and hospitals sought to form up for lost revenue by trimming staff through attrition, Stimpfel says.

 

"Then they never regained those staffing positions," she says. "So there's frustration that administrators might not are putting enough resources into restaffing when there have been staff available."

 

During earlier waves, hospitals also sent some nurses into COVID-19 wards to assist out albeit they were trained for other specialties. But Stimpfel says asking a neonatal nurse to figure within the ICU with a COVID-19 patient – a high-risk environment involving possible exposure to a potentially deadly contagion – was an enormous ask.

 

"Not all nurses are trained in critical care," she says. "There are different specialties that nurses are prepared for, and you cannot prepare a nurse to require care of those intensely ill patients, and do this overnight. That was still such a leap for them to be put into that kind of situation."

Meanwhile, colleges and nursing schools are urged to expand capacity to graduate more caregivers, with experts saying the more trained hands working during a COVID-19 ward, the higher . during a recent speech to graduates, McCauley, the Emory school of nursing dean, says she compared the category to soldiers on the front lines of a battle: "I said, 'In ways, you job my memory of my colleagues once I graduated: nurses that were serving within the Vietnam War ."

 

The new nurses "are walking into a workforce where most are exhausted," McCauley says. "These new graduates can delay that workforce just with their youth, their enthusiasm. They're willing to travel the additional mile."

 

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Still, McCauley acknowledges that in battling an epidemic that's mutated to become more contagious, youthful enthusiasm isn't a substitute for the "wisdom and professionalism" that comes with experience. And, she says, treating COVID-19 patients who got sick because they chose to not get vaccinated – and should have spread the virus to people – are often disheartening.

 

During this fourth wave, nearly all of these hospitalized "are unvaccinated people," she says. "The saddest thing is that the children – unvaccinated children whose parents couldn't get them vaccinated, albeit they wanted to," because a vaccine isn't approved for young children yet.

 

Ultimately, experts say, nurses nationwide will need someone to worry for them to assist keep more of them on the work .

 

For those currently within the profession, "there just must be tons more support … to assist look after the nurses that are getting to carry around this long-term trauma," Stimpfel says. "It's just impossible to travel through this crisis, then repeat the crisis, and not have anybody caring and helping the front-line workers to process it, and to urge through it during a healthy manner."

 

But it could take years before staffing levels get to a far better place.

 

"There are some experts that would probably model it better than I can, but i might say it's getting to be a minimum of six to 10 more years before we recover from this," Stimpfel says. "And that's due to factors that were already live before COVID."

 

Alexander, the Bay Area ICU nurse, is frank.

 

"We are all super, super tousled ," she says.

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