“Totally exhausted”: latest wave of Covid pushes American nurses to the brink


Employers and healthcare unions have called on the federal government to tackle crippling workforce shortages as deadly Covid-19 wave sweeps across the United States and tens of thousands of frontline workers are laid off for refusing to be vaccinated.

The acute shortages of nurses have forced hospitals in the worst-affected states to ration patient care and seek support from the National Guard, which has 13,000 staff deployed on pandemic support duties. But the scale of the crisis, which has resulted in daily Covid-19 death rates rising to levels last seen in last winter’s outbreak, has prompted demands for financial aid and reforms. to deal with pre-pandemic issues.

The introduction of vaccination mandates for health workers could lead to a new exodus of nurses from the profession, according to health experts. New York officials on Monday warned that thousands of unvaccinated healthcare workers could be sacked when the deadline expires, with up to 16% of the state’s 450,000 hospital workers still missing. received vaccine.

“Any staff member fired due to a refusal to be vaccinated would not be eligible for Unemployment Insurance without a valid request for medical accommodation approved by a physician,” said Kathy Hochul, Governor of New York.

The vaccine mandate battle in New York will have a big impact on healthcare nationwide, as similar rules are put in place by state and federal authorities. It comes as unions and employers warn some states’ healthcare systems are already near breaking point, prompting many exhausted frontline workers to leave the industry.

Critical care staff check patient in Jonesboro, Arkansas: Pandemic has prompted more nurses to quit the profession out of exhaustion and fear of spreading disease to their families © Houston Cofield / Bloomberg

Just over 15% of nurses left their jobs in the first year of the pandemic, up about 5 percentage points from the previous year, according to a McKinsey survey. One in five nurses said she may step down from her role of providing direct patient care within the next year, according to the survey.

“The nurses are totally exhausted, both mentally and physically, after 18 months of this pandemic. . . Now they are seeing death and are dying just about every day at the same rate as last year, before we had a vaccine, ”Ernest Grant, president of the American Nurses Association, told the Financial Times.

The demand for traveling nurses to the United States has skyrocketed in recent months;  Total number of open jobs ('000)

He said it was frustrating for nurses to see so many deaths that could have been prevented by vaccines, noting that WADA supports vaccination mandates.

The AMA, which represents 4 million registered nurses, said there was a staff shortage before Covid-19 due to structural issues, including low salaries. But the pandemic has prompted more nurses to quit the profession out of exhaustion and fear of catching the disease and bringing it home to their families. The shortfall could reach 1 million nurses nationwide, Grant said.

WADA called on the Biden administration to call a crisis meeting with hospitals, unions, government officials and other experts to work on solutions. Serious nursing shortages could “have long-term repercussions on the profession, the entire health care delivery system and, ultimately, the health of the nation,” he warned this month. -Here in a letter to Xavier Becerra, US Secretary of Health.


Possible national staff shortage estimated by the American Nurses Association

The strain is most felt in states where vaccination rates are low and hospitalization rates remain high despite recent declines in other parts of the United States.

West Virginia has the highest Covid intensive care unit rate in the United States, with 16 intensive care patients per 100,000 people, according to the FT’s analysis. The mountain state also has the lowest elderly vaccination rate in the country, with just 79% of those over 65 having received at least one dose.

The Rocky Mountains and the northwestern states are also hot spots. Idaho has 45% more Covid intensive care patients than last winter, while Montana and Wyoming have also passed their winter peaks. Vaccination rates for seniors in both states are lower than the national average.

The growing burden on medical personnel has forced authorities in Wyoming, Idaho, Kentucky and Tennessee to recruit National Guard soldiers to assist them in non-clinical tasks.

Michael Scherneck, president of the Southeast Georgia Health System, said a third of its registered nurses had left since the start of the pandemic, and now about half of the group’s recruits were travel nurses with short-term contracts. Before the pandemic, Scherneck said, he was paying $ 70 to $ 80 an hour for a travel nurse but, “lately when we hit that increase we paid up to $ 212 an hour.”

“We made these investments because patients needed care,” he said. “We don’t have the capacity to say, ‘we are closed today, go to another hospital,’ because there is no other hospital nearby.”

Travel nursing, where nurses travel between different hospitals on short-term contracts to fill staff shortages, has increased during the pandemic. There are 48,000 travel nurse positions listed nationwide, nearly three times the number available at the same time last year, according to Aya Healthcare, a healthcare staffing company.

“Right now we are seeing travel nurse compensation packages ranging from around $ 3,000 to $ 6,000 per week and this has more than tripled since before the pandemic,” said Sophia Morris, vice president management of Aya’s accounts.

Critics warn that the large number of RNs resigning from permanent positions to take on higher-paying travel positions is undermining the ability of hospitals to respond to the crisis.

“It’s a problem that continues because when I’m understaffed I have to use a travel contract, which attracts nurses from elsewhere,” said Phillip Coule, chief medical officer at Augusta University Medical Center in Georgia. .

The American Hospital Association urges Congress to prioritize funding that tackles staff shortages, including speeding up visas for foreign nurses, expanding nursing schools, and introducing measures to combat the staff burnout.

“Greater investment in efforts to address suicide, burnout and behavioral health disorders among healthcare professionals is essential to protect our current and future workforce,” said Robyn Begley, Senior Vice President of Workforce at AHA.

The morale of registered nurses working alongside higher-paying colleagues on travel contracts is suffering amid the Covid-19 crisis.

“I thought the HIV epidemic was bad when it started, but Covid-19 is really overwhelming,” said Marsha Martin, who works in the intensive care unit at the University of Florida Hospital in Gainesville.

“Some of the people we take care of are very young. Thirties, twenties and even small children suffer from it – it’s really sad, ”she said.

Martin, who worked as a nurse for 37 years, fears that young nurses will leave the profession or that those who remain will join the growing number of people who are becoming itinerant nurses.

“Travel nursing pits one hospital against another and is really a form of price escalation. It is unbridled capitalism. I just don’t think it’s fair, ”she said.


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