OMAHA, Neb. (WOWT) – Leaders of hospitals around the state are asking Nebraskans to take extra care in the coming weeks as the healthcare community braces itself for an expected surge in COVID-19 hospitalizations.
“We’re just starting to feel the wave of omicron hospitalizations,” said Jeremy Nordquist, president of the Nebraska Hospital Association, noting that hospitals across the state added 70 COVID-19 patients two weeks ago and 80 patients last week.
The trend isn’t good, he said. “We’re on a path that isn’t very sustainable for our hospital systems.”
Monday afternoon, he led a panel of three doctors from different health systems in Nebraska about the struggles healthcare workers are having at this stage in the COVID-19.
Josie Abboud, president and CEO of Methodist Hospital, said medical staff from across the state were on a call Monday led by Dr. James Lawler of the Global Center for Health Security that showed Nebraska COVID-19 hospitalizations at 560 now, with models showing upwards of 770 patients in a couple weeks’ time.
The hospital administrators all expressed concern about where these patients will go.
“We could see a doubling of hospitalizations due to COVID in Nebraska over the next two to three weeks. That alone would overwhelm our healthcare system, but we’re also facing one of the worst staffing challenges we’ve had during COVID,” Nordquist said.
It’s not because of vaccine requirements. Among the first eligible for COVID-19 vaccinations, the healthcare community has had an exceptionally high rate of vaccination even before they required all staff to be vaccinated and worked hard to slim that gap even further before their company deadlines kicked in.
One of the biggest staffing challenges, they said Monday, is community spread.
When the positivity rate is high, it also affects their staff, Abboud said.
Just like other sectors experiencing staffing concerns as employees call out with COVID-19, healthcare workers are also getting put on the sidelines because they test positive or a member of their family or household had tested positive. As of Monday, she said, Methodist had 178 employees out; roughly 50 of those absences — about 28% — are nurses.
“Our supply of healthcare workers and beds is being outstripped by the demand for care and services — and we need the public’s help. We do not have an infinite supply of … beds and nurses,” said Todd Consbruck, CEO of Avera St. Anthony’s Hospital in O’Neill, Neb.
Acknowledging the increase in cases even among the vaccinated as the omicron variant moves into the state, he urged Nebraskans to vaccinate not only to protect their loved ones and themselves but as a means of protecting the state’s medical workforce as well.
Ivan Mitchell, CEO of Great Plains Health in North Platte, said in some Nebraska communities, a little outbreak in certain departments meant a reduction in services. In some places, things like a cath lab just aren’t available because those who can run it are out sick because of COVID-19.
“We’re a highly vaccinated group of people, and it’s still taking our workforce out along with it,” Consbruck said, thanking those who have been vaccinated and especially those who have received their COVID-19 booster shots.
It’s not a perfect means of protection, but it’s another tool that helps, he said.
Staying home when you’re sick is another big help to healthcare workers.
When you’re ill, take it seriously, Consbruck said. If you continue to socialize when you’re not feeling well, then you’re exasperating the problem, exposing many others — some even in your own family, he said, and that can create “hotspots” of people who needlessly got sick.
“We need to change this curve again, now, or we’re going to be in a lot of trouble a couple weeks from now,” he said.
For some hospitals, things are already heading in dire directions. In some areas, hospitals are already at the breaking point, Mitchell said.
In rural Nebraska, there are some hospitals that maybe don’t have the proper equipment or specialized staff to care for those patients. In such places, Mitchell said, there have been families who have had consequences because of where things stand at right now.
Or those patients just have to wait — sometimes up to four hours for even the sickest patients — to be able to get a bed, Consbruck said.
In some cases, people are coming to hospital emergency departments when they don’t need to. Abboud said some have come to Methodist EDs for a COVID-19 test or to check their oxygen levels.
“This isn’t the place for that,” she said.
In the meantime, many departments are having to triage incoming patients, overflowing normal patients into other areas of the hospital. For example, many patients last week were overflowed into post-op departments, Abboud said, urging Nebraskans to be patient when seeking any kind of care.
In some cases, procedures are getting canceled because the patient shows up with symptoms. If the symptoms are able to be managed without hospital care, those patients are sent home, she said.
“We don’t want to provide a lesser quality of care,” she said, noting her concern when thinking about what would happen should several physicians in the same specialized departments be out with COVID at the same time.
Without a directed health measure in place, Abboud said, Methodist has also considered canceling Class C surgeries, which can be more urgent — like a surgery that is a treatment for cancer.
While sick staff plays a role in the shortages, the other concern is the sheer amount of vacancies.
Abboud said Methodist had 904 open posted positions as of Monday afternoon. And it’s not just clinical positions; admin and IT jobs are also needing to be filled, she said.
Some of those are baby boomers in healthcare jobs who held on past retirement and are now opting to retire, with much gratitude from their colleagues left behind for the amount of time they spent supporting the rest of the ranks.
Mitchell said he’s seen peaks and valleys before, and certainly, there have been “short-staffed” situations — but never like this. Even the increase in “locum,” or “traveling,” positions isn’t helping to alleviate the gaps.
“We always try to limit those candidates because they’re very expensive for our health systems; but at this point, we can’t even find them,” Mitchell said.
But because those working in the travel market make as much in 13 weeks as they would in four or five months, they will often take a couple months off after that to recuperate.
“It all just came to a head during the pandemic,” he said.
The shortages are also impacting the ability of hospitals to help each other out.
Under normal circumstances, Mitchell said, the hospitals typically turn down about 10% of transfer requests, but now we’re turning away 30-35% of those calls because they can’t accommodate their care.
Another layer to the staffing problem is a lack of new healthcare professionals entering the field. There are not enough graduates coming out of the schools. Additionally, Mitchell said, some are getting turned away from nursing school because of the restrictions and requirements that it takes to get into those schools.
PLEA FOR POLICY
The problem is only going to get worse, Nordquist said.
National estimates indicate Nebraska will be short by 5,400 nursing professionals in 2025, he said. Some of that is due to the increase in necessary care for an aging baby boomer population — but that was a known surge.
He suggested that it’s time for state and national policymakers to “look at all avenues to fix this” and prepare for this same sort of crisis-level need to occur again.
They should also bear in mind that it’s going to take a while to rebuild after the COVID-19 health crisis — and for the healthcare workforce to recover.
Many medical workers across the state are also carrying a lot more than bigger workloads.
“They’re very tired from a physical, emotional, mental health well-being standpoint,” Abboud said. “This continues to cycle for them, and it’s very stressful and very traumatic for some.”
They’re doing all they can, in many cases caring for patients whom they wouldn’t normally be assigned, or struggling to find placement for patients equipped to treat them.
All the while, they keep hearing people talk about how they wished their loved one they’re caring for — or who have died — would have only been vaccinated.
“It’s heartwrenching to watch families twist in the wind while they try to find beds,” Consbruck said.
For some, it’s too much, and “compassion fatigue” among healthcare workers is really a challenge, she said. Some are saying they just need a break; some ask to work in another area in the hospital, or move to more lucrative traveling positions.
“We’re doing all we can to support them,” Abboud said.
She also noted how much the medical workforce appreciates those in the community who still support them and help raise their spirits — something that isn’t always commonplace these days.
“Nebraskans as a whole are a compassionate caring group. But we are seeing segments of society right now who are not giving healthcare workers the respect and kindness that they deserve,” Consbruck said.
BREAKING THROUGH THE NOISE
Compounding “compassion fatigue” is the war on misinformation, which has put healthcare professionals into positions they didn’t see coming.
“The solution is vaccination,” Mitchell said.
It’s mind-boggling to doctors that people won’t get a safe, effective, and FDA-approved vaccination, he said.
“When they come into the hospital and are having a difficult time breathing, they then want everything experimental,” he said.
The best way to support healthcare workers is to get vaccinated.
“That really is the solution, so you’re going to hear us continue talking about it,” Mitchell said.
In some areas, Abboud said, continuing clinics help. And people are still asking about them when they come into their doctor’s offices, so there’s some encouragement there, she said.
Consbruck lamented that the decision, for many, is becoming a more emotional or political decision than a medical one.
Still, the medical community is doing what they can to break through the “noise and clutter” to reach those people who aren’t wanting to get vaccinated, Nordquist said.
Despite a numbness to COVID-19 settling into some communities, they said the data isn’t overstated and it isn’t just about those with comorbidities.
Nobody is in a hospital bed that doesn’t need to be, even if all they’re needing is oxygen support, Abboud said.
In some smaller Nebraska communities, they are seeing the highest case numbers and positivity rates they’ve ever seen.
“We have a fair amount of towns whose populations are equal to or less than the number of COVID deaths we’ve had here,” Consbruck said.
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