Georgia short of intensive care nurses as winter threatens surge of coronavirus cases

As Georgia braces for a cold-weather coronavirus surge that could collide with the flu and send patients flooding into hospitals, facilities across the state are worried they don’t have enough nurses to treat their sickest patients.

Nurses fear contracting Covid, or making mistakes because of high workloads

As Georgia braces for a cold-weather coronavirus surge that could collide with the flu and send patients flooding into hospitals, facilities across the state are worried they don’t have enough nurses to treat their sickest patients.

Employment ads show hospitals from Albany to Savannah, Augusta to Rome, trying to hire nurses to meet the wave. Augusta University Health is seeking 250 nurses, partly to staff its new COVID-19 beds and an ICU it converted into a COVID-19 ICU. Elbert Memorial Hospital in northeast Georgia is now approaching the state government for nurses.

One temporary health care staffing website that connects traveling nurses with staffing agencies shows demand for intensive care unit nurses more than tripled in Georgia during the first week of November, compared to the last week of October.

And demand in October was already high, at 373% above the level from October 2019, according to data provided by NurseFly.

Early in the pandemic, when some Georgia hospitals were hobbled by a nursing shortage, other hospitals were furloughing staff as their facilities emptied out. That bolstered the ranks of nurses able to help in hot spots.

Now, with the coronavirus widespread in Georgia and across the nation, hospitals are competing for a shrinking pool of nurses.

“Right now, it’s just a national market, because I think all the hospitals across the country are recruiting the same nurses,” said Richard Lamphier, a pediatric registered nurse and president of the Georgia Nurses Association.

For Augusta University, newly minted nurses from local schools are crucial. But to also get experienced nurses, the health system has begun hiring from the Philippines, part of a plan set in motion last year. “The demand is just greater than the supply” said Laura Brower, chief nursing officer of AU.

Augusta University Health is trying to hire 250 nurses, partly to staff its new COVID-19 beds and an ICU it converted into a COVID-19 ICU. To get experienced nurses, the health system has begun hiring from the Philippines, part of a plan set in motion last year. (Augusta University Health)
Augusta University Health is trying to hire 250 nurses, partly to staff its new COVID-19 beds and an ICU it converted into a COVID-19 ICU. To get experienced nurses, the health system has begun hiring from the Philippines, part of a plan set in motion last year. (Augusta University Health)

‘They’re scared’

The pandemic has taken a heavy toll on the profession. Some nurses have died. Others fell sick and recovered but spent weeks off work. Others decided they’d just had enough.

Dana Horton, a radiology registered nurse at the Atlanta VA Medical Center and the local union director for National Nurses United, said that after a long lull at the hospital, COVID-19 numbers are ticking back up, creating new fears about adequate personal protective equipment and staffing.

“I’m hearing of a lot of nurses coming out of the system because they’re scared,” Horton said. “For their own health, for their family’s health. Some of them are taking care of older parents that they’re concerned about.”

Union member Melissa Turner works as a registered nurse in the Atlanta VA’s medical surgical telemetry unit, where before the pandemic she specialized in treating cardiac patients. Because so many nurses have been shifted over to the new coronavirus units, she said she’s now handling peritoneal dialysis patients, too, which is beyond her training. Instead of handing four patients at a time, she sometimes is in charge of six.

“I feel that I’m going to risk my license," she said. "I feel that I’m going to do something, or not do something right for the patient, and it’s just a very difficult situation.”

Turner said she worries that veterans won’t get proper care if the VA hospital gets slammed with another Covid surge on top of flu season.

“This time of year we get a bunch of pneumonia patients," Turner said. "We get a lot of (congestive heart failure), alcohol withdrawal — they come to us by mass numbers during this time of year, too. And homeless veterans, too, because it’s cold outside.

"So how are we going to deal with that influx of patients if we’re already short?” she said.

Dana Horton, a radiology registered nurse at the Atlanta VA Medical Center and the local union director for National Nurses United, is seen here protesting inadequate personal protective equipment outside the VA in April. Horton says that with COVID-19 cases ticking back up, workers are nervous again about the PPE supply.  (Ben@BenGray.com for the Atlanta Journal-Constitution)
Dana Horton, a radiology registered nurse at the Atlanta VA Medical Center and the local union director for National Nurses United, is seen here protesting inadequate personal protective equipment outside the VA in April. Horton says that with COVID-19 cases ticking back up, workers are nervous again about the PPE supply. (Ben@BenGray.com for the Atlanta Journal-Constitution)

Infection experts across the country have warned about winter. One of the most dangerous aspects of coronavirus is how it builds up in the air indoors. Americans so far have coped by moving activities outside. But soon it will be too cold for that, and people are weary of restrictions.

If lax pandemic behavior meets a strong flu season, infections and inflow to hospitals could be unprecedented.

The prospect bodes ill for both patients and staff — in not just old hotspots but in new ones.

“We’re already struggling to find staff,” said Kerry Trapnell, CEO of Elbert Memorial Hospital in northeast Georgia. “There’s definitely reason to believe that the patient load’s going to be worse this time. I wish I knew. That’s the fear.”

It’s different from the spring, when the hospital could shift nurses from departments that had been shut down.

“We don’t have that advantage of using PRN staff” — nurses working second jobs at Elbert — “from other places anymore,” Trapnell said. “They’re just pulled, and they’re working full time everywhere else.”

Very sick COVID-19 patients require intense care, meaning more dedicated nurse time. And if test results come slowly — which they often still do — every patient must be treated as possibly infected.

The latest White House Coronavirus Task Force report moved Georgia back into its red zone, the most severe category for spread of the virus. With other states faring far worse, the report ranked Georgia 40th in the nation for average daily new coronavirus cases.

NurseFly, however, ranks Georgia 4th in demand for ICU travel nurses, behind California, Texas and Florida.

Lamphier, of the Georgia Nurses Association, said Georgia is probably high on the list because it had one of the nation’s worst shortages before the pandemic, exacerbated by low pay and more lucrative opportunities in other fields. Now Georgia nurses can use Atlanta’s airport to quickly travel to hot-spot states for high-paying temporary jobs.

Medical staff at Elbert Memorial Hospital move aside for an EMS team wheeling a patient down the hall of the acute care unit. (Curtis Compton / Curtis.Compton@ajc.com)
Medical staff at Elbert Memorial Hospital move aside for an EMS team wheeling a patient down the hall of the acute care unit. (Curtis Compton / Curtis.Compton@ajc.com)

Credit: Curtis Compton

Credit: Curtis Compton

The bleeding continues

It doesn’t help that some health care workers have seen pay cuts and many have navigated supply shortages in the pandemic, including shortages of personal protective equipment.

The PPE shortages have prompted nurses and others to lodge complaints with the U.S. Occupational Safety and Health Administration accusing hospitals, doctor offices and other employers of putting them at risk.

Because of the increased dangers, in April the Georgia Nurses Association asked Gov. Brian Kemp to team up on a plan to offer $250 in non-taxable hazard pay every two weeks to front-line nurses, EMTs, paramedics and hospital and nursing home support staff.

Kemp never acted on the request, though the state government has taken other steps to try to ease the shortage.

Early in the pandemic, the Board of Nursing loosened its rules so that out-of-state nurses could quickly obtain temporary licenses, and nursing school graduates can go to work during the pandemic before taking the licensure test.

A spokesman for the governor said that by year’s end, the state will have spent $250 million augmenting staff for hospitals and long-term care facilities. The money came out of the $2.2 trillion federal Coronavirus Aid, Relief, and Economic Security Act.

But that has only made a dent, said Darrell Thompson, president of the Board of Nursing.

“I think the demand is just so high,” he said. “And these Covid patients get really, really sick and go to intensive care units, and not every nurse has that skill.”

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