Hospitals are competing for nurses as coronavirus surges across the nation

FENTON, Michigan — As the coronavirus pandemic surges across the nation and infections and hospitalizations rise, medical administrators are scrambling to find enough nursing help — especially in rural areas and at small hospitals.

Nurses are being trained to provide care in fields in which they have limited experience. Hospitals are scaling back services to ensure that they have enough staff to handle critically ill patients. And health systems are turning to short-term travel nurses to help fill the gaps.

Adding to the strain, experienced nurses are “burned out” from dealing with the coronavirus pandemic, and some are quitting, says Kevin Fitzpatrick, an emergency department nurse at Hurley Medical Center in Flint, Michigan, where several nurses have left just in the past month to work in hospice or home care or at outpatient clinics.

“And replacing them is not easy,” Fitzpatrick says.

He says the emergency department at his hospital is operating at about five nurses short of its optimal level at any given time, and each nurse typically cares for four patients as COVID-19 hospitalizations again are surging.

Hospital officials did not respond to requests for comment.

The departures of nurses from hospitals aren’t surprising, according to experts, given not only the psychological toll but also that many nurses trained in acute care are over 50 and at increased risk of complications if they contract the virus, while younger nurses often have children to worry about.

“Who can actually work and who feels safe working are limited by family obligations to protect their own health,” says Karen Donelan, professor of U.S. health policy at Brandeis University’s Heller School for Social Policy and Management. “All of those things have been factors.”

With total confirmed coronavirus cases surpassing 9 million in the United States and new daily infections rising in most of the country, the need is only increasing.

Wausau, Wisconsin-based Aspirus Health Care — which operates five hospitals in Wisconsin and four in small communities in Michigan’s Upper Peninsula — is offering $15,000 signing bonuses for nurses with at least one year of experience and hiring contract nurses through private staffing companies to handle a surge in hospitalizations that prompted the company to nearly quadruple the number of hospital beds dedicated to coronavirus patients.

Aspirus also is moving nurses around among departments and facilities as hot spots emerge, according to Ruth Risley-Gray, its senior vice president and chief nursing officer.

Outside help is still needed in part because some nurses have gotten sick from or were exposed to the cornavirus during the current wave, which “came with a vengeance” starting in August, Risley-Gray says. At one point in mid-October, 215 staffers were in isolation after showing symptoms or being exposed to someone who tested positive.

Aspirus recently hired 18 nurses from outside agencies and might need more if this latest surge continues.

Hospitals nationwide are competing for the same pool of nurses, offering pay ranging from $1,500 a week to more than $5,000, according to April Hansen, executive vice president of San Diego-based Aya Healthcare, which recruits and deploys travel nurses.

Hansen says demand for its services has more than doubled since early in the pandemic, when the greatest need was in hot spots like New York and New Jersey and then moved to southern states. In recent weeks, new hot spots have emerged in places like the rural upper Midwest and southern-border communities like El Paso, Texas.

Placing nurses where they’re needed most is “like a giant game of whack-a-mole,” says Hansen, whose company has about 20,000 openings for contract nurses.

In North Dakota, where infection rates are exploding, hospitals might cut back on elective surgeries and seek government aid to hire more nurses if things get worse, North Dakota Hospital Association president Tim Blasl says.

In Wisconsin, Gov. Tony Evers issued emergency orders making it easier for nurses from elsewhere to practice in his state and for retired nurses to come back.

In Texas, Gov. Greg Abbott recently announced he was sending 75 nurses and respiratory therapists to El Paso to help handle the city’s surge.

To combat the emotional toll and fatigue that comes with caring for COVID-19 patients, Aspirus has been giving nurses microbreaks and quiet places to get away and collect themselves.

Robert Gardner, who’s assigned to a hospital in a small town about 20 miles west of Atlanta, says he did search-and-rescue in the Coast Guard during Hurricane Katrina, and the pandemic is “a lot worse.”

He worked at a large New Jersey hospital when that state was swamped by the virus in the spring and worries flu season could bring further chaos to hospitals. But he’ll stick it out.

“It’s not even a question,” Gardner says. “Nursing is a calling.”