A shrinking band of Southern nurses, old-fashioned bass in another vibrant wave

PASCAGOULA, ma’am. – Bobbie Anne Sison was arriving at the hospital just before dawn when she received a panicked call from one of her best nurses saying she couldn’t come to work because her car was too hot on 63rd Street. Ms. Sison, a nurse manager at Pascagoula Hospital, slammed on the brakes, turned around, and ran to get her.

‘We have staff dropping like flies from Covid so there’s no way I’d leave her on the side of the road,’ Ms Sison said hours after she walked the hallways of her 350-bed hospital, which has gradually filled with Covid patients after a month of lull.

On Sunday, 106 coronavirus patients were being treated at Song Hat Health System, a network of three small county-owned hospitals along the Mississippi Gulf Coast, up from a dozen patients at the start of the month. With 40% of all Covid-19 tests in Pascagoula coming back positive and about 100 hospital staff recovered, Ms. Sison tries not to think about what the coming days will bring.

“I just don’t know if we can do this again,” she said.

Even if new cases peaked and began to decline in the Northeast and Upper Midwest, the country’s hospitals are still facing an increasing number of patients. In Mississippi, the latest wave of infections pushed nearly all of the state’s acute care hospitals capacity.

At Pascagoula Hospital, the city’s only acute care medical facility, a wave of departures left 80 facilities unfilled for registered nurses, forcing administrators to leave one one-third of the hospital beds. By the end of last week, all the remaining beds were full, leading to a system-wide redundancy alarm. With nowhere else to go, coronavirus patients in the ICU who are well enough to be transferred to another unit must stay. Also stuck are some critically ill patients in the ER who cannot be transferred to the ICU, where care is much more precise.

Lee Bond, chief executive officer of Sing River, said the current increase was simply exacerbating the severe labor shortages that state hospital leaders and public health officials are facing. that will last long after Omicron disappears.

“The real crisis we are facing right now is the basic shortage of nurses,” he said.

The nation’s frontline medical workers were already running in smoke even before Omicron showed up. The successive waves of illness and death left them exhausted and paralyzed; almost 1/5 yes quit job in the past two years. And they’re angry – at patients who refuse vaccinations, at hospital executives who won’t spend the money needed to maintain nurse-patient safety ratioand at political leaders, who called them “healthcare heroes” while protesting the mandates for masks and vaccines that could reduce the tsunami of new infections.

Labor shortages are especially acute for small, nonprofit safety net hospitals like Sing River, where millions of Americans seek care. Financially flimsy even before the pandemic, they were unable to match the exorbitant salaries of traveling nurse agencies and large health systems, accelerating the rate of staff shortages that threatened their viability. their ability to provide quality care. Traveling nurses can earn more than $200 an hour, much more than the $30 most nursing staff in Mississippi make.

“Many community hospitals are wondering how to keep the lights on,” said Tim Moore, president of the Mississippi Hospital Association.

Financial stress was exacerbated when Mississippi and other southern states refused to expand Medicaid. For Mississippi, that means an additional $600 million in federal aid annually, according to state economistand 11,000 new jobs are added each year, most of them in the healthcare sector.

Governor Tate Reeves and other Republican leaders who dominate the state’s government have also resisted calls to spend a significant portion of federal coronavirus relief aid for bonuses that could help employees. health care workers have difficulty.

Kelly Cumbest, 45, a registered nurse who manages patient care at the ER, said in recent months he has only received one application for 24 openings at his department. “It’s not just Omicron that worries us,” he said. “What scares us is that we don’t have someone to take care of heart attacks, strokes and car accidents, and that’s something politicians and the public really don’t understand.”

The staffing crisis at Pascagoula Hospital was not immediately apparent to visitors. The doctors and nurses exchanged cheers and reviews about the day’s cafeteria fares as they entered and exited the ward. But the flashing purple lights above half a dozen doorways tell a different story: They signal a patient’s unanswered call — asking for water, asking for help with defecation, or increasingly asking for help. Hands clean up after they can’t wait anymore. .

Sometimes needs are more important. Deborah Briggs, 64, a newly hospitalized Covid patient, threw away the oxygen mask with a feverish agitation and difficulty breathing. “I’m heating up,” she gasped as the three nurses returned the masks to her face and then lifted her to a position that would allow her lungs to fully expand.

One of the nurses, Teresa Phillips, sighed and tried to explain the challenge of dealing with the complex medical needs of so many patients with 25% fewer staff. “I want to make sure my patients are showered, given their medications on time and continuously assessed their vitals, but you can’t do that when you’re this skinny,” said Ms Phillips, who just got back to work after fighting Covid for the second time.

When asked how they are fighting the pandemic in two years, almost every nurse at Pascagoula Hospital is emotional. Caroline Olivera, 24, a “baby nurse” who claims to be the first person to take her first job as a nurse when the pandemic began, wept as she described the physical exhaustion caused by the overtime shifts. constant and the pain of death is too much. “You know the saying ‘only the fittest survive’? Well, that’s me,” she said.

The residents of Pascagoula, an industrial port town of 22,000 people are still recovering from the devastation caused by Hurricane Katrina. For a while, unyielding loyalty to the community has gone a long way in convincing many nurses to stay, despite some of the lowest wages in the country and worrisome vaccination rates. Only 46 percent of county residents are fully immunized.

That devotion began to fade during last summer’s disastrous Delta spike, when administrators were first forced to hire travel nurses.

As the Delta wave subsided, many holders decided that they could no longer resist the attraction of the currency and began to walk away in waves. Some have taken jobs in Mobile, Ala. 40 minutes away, allow them to stay home with family.

“You can’t blame them,” said Jessica Samma, a registered nurse and 14-year veteran of Pascagoula Hospital, one of the few elderly people left, though she admits she does. was tempted to join them.

The departure has had an adverse effect, forcing the hospital to hire more traveling nurses and threatening the hospital’s already precarious financial position. On some days, nearly 80% of nurses in some wards are on short-term contracts, hospital leaders said.

As a result, Sing River has racked up $30 million in additional costs during the pandemic, said Bond, its chief executive. He and other hospital officials were Mississippi state leaders are upset uses a quarter of $1.8 billion in federal pandemic relief funds to provide $20,000 in retention bonuses for nurses who agree to stay in the state for two years. Lawmakers countered with a much less generous proposal that would fund a bounty of about $1,000.

With 2,000 unfilled opportunities for registered nurses and some of the worst health outcomes in the country, hospital executives worry about Mississippi’s long-term prognosis. Mr Lowe, of the state hospital association, said he feared that residents would blame healthcare workers for any substandard care they received, an aversion that would put many people at risk. quit the job.

That momentum could be felt last week as 20-year-old Brandon Russell, a certified nursing assistant, struggled to stay healthy as he took care of the needs of nearly a dozen Covid patients. Before entering each room, he must be dressed in a surgical gown, gloves and two masks, even when the task is as simple as turning off the lights. After leaving the room, all such protective equipment must be removed. This process is repeated dozens of times a day. The job pays $10 an hour.

Mr. Russell, who recently recovered from Covid, said the past few months had caused him to give up his aspirations to become a registered nurse. “I love my patients but I’ll be honest with you, I’m ready to quit,” he said. “Whenever I go to nursing school it doesn’t help, every nurse here tells me not to do it.”

That sentiment drives Miss Sison, 36, the chief nurse practitioner, who can’t seem to get a crush on her staff. Over the past few months, she has ceased to count the times she has had to comfort co-workers, who have been irreparably exhausted or reeling from successive deaths. A nurse had a nervous breakdown in her office, she said, and then quit.

“You become a nurse to cure people, but there have been weeks in the pandemic where we feel like we have lost more lives than we have saved,” said Ms. Sison, standing in the hallway with a fellow nurse. . They began to recall some of the Covid deaths: the 18-year-old begged for relief as he gasped for breath; 27-year-old father left behind 4 young children; The elderly man took his last breath minutes before his family came to say goodbye.

“Yes, this is what we signed up for, but people forget that we are still human and we have feelings,” Ms. Sison said. “You try to check it at the door when you get home, but you can’t.” For Ms. Sison, the losses are personal. She was 33 weeks pregnant in March 2020 when the pandemic hit Pascagoula, and after weeks of battling a mysterious illness, the baby, a boy, was still stillborn. Doctors gave the news the same day the hospital received its first coronavirus patient. An autopsy determined that Covid likely caused his death.

Three weeks later, Ms. Sison was back at work. “They were there for me,” she said of her colleagues, “and I would not have left them at such a terrible time.”

Just then, an overhead speaker began playing Brahms’ familiar lullabies. The medical staff up and down the corridor stopped to follow their tracks. The song marks the birth of a baby at Pascagoula hospital, “a rare moment of goodness,” one woman said.

It reminded them of the days when hospitals played “Don’t Stop Believin” every time a Covid patient was discharged. In a time of constant darkness, the song is a source of joy and hope.

But that was before, when most people at the Pascagoula hospital believed that science and self-sacrifice would eventually prevail.

“We thought we were going to beat this virus,” Ms. Sison said, her voice trailing off. “We don’t play that song anymore.”

https://www.nytimes.com/2022/01/23/health/covid-mississippi-nurses.html A shrinking band of Southern nurses, old-fashioned bass in another vibrant wave

Fry Electronics Team

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