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JW Cowan began his career 40 years ago trying to recruit nurses in what he now calls “the land of the forgotten man” in rural Alabama.
“A good rural nurse, I don’t know anything more difficult than that,” he says. “They persevere. They put the community, they put the hospital first and my hat goes to them.
Today, he is still trying to recruit nurses in Choctaw County, near Mississippi, except that he does so in the event of a pandemic. And the work has only gotten harder, and nurses are in increasing demand across the country, making it even more difficult to staff rural hospitals.
Cowan is an administrator at Choctaw General Hospital. Its staff are working back to back, in 12-hour shifts during the pandemic. One nurse worked a 96-hour week, and it is not uncommon for nurses to work seven days in a row to keep hospital staff.
As at Choctaw General, hospitals in Alabama are reporting a shortage of nurses. COVID-19 cases are increasing ahead of a holiday season that experts say could increase the rate of spread.
COVID-19 is time consuming for staff as patients require intensive care. Yet a growing number of staff are sick because they have been infected or exposed to COVID-19, said Don Williamson, president of the Alabama Hospital Association.
He said many hospitals in Alabama were already understaffed before the pandemic.
“Right now we’re in a very worrying position, and I think in an increasingly unstable position with respect to COVID,” Williamson said, adding that the average 7 days of hospitalization for the State has almost doubled in the past five weeks.
Butler’s Choctaw Hospital is short of five nurses and one lab person, Cowan said. Several nurses at the hospital are at home with COVID-19. Two may never return because their illness was so severe. However, it is not easy to bring in reinforcements.
Williamson says he’s spent hours this week on the phone with hospitals facing staff shortages to deal with the influx of COVID patients. Some, like the University of Alabama at Birmingham, do not face an immediate staff shortage.
“(Most nurses) want the glamor and the lights of Birmingham, Mobile and Tuscaloosa. They don’t want to come to Butler, Alabama, ”Cowan said.
Hospitals in large urban areas have a chance to compete for itinerant nurses in a nationwide bidding war that has driven nurses’ salaries up during the pandemic outbreak, sometimes pushing nurses away from small rural hospitals for concerts more remunerative in cities.
“It has certainly been a challenge to recruit nurses because the market has been very competitive and this is largely due to COVID,” said Andy North, spokesperson for DCH Hospital in Tuscaloosa.
Baptist Health Hospitals, located in Montgomery and Prattville, have been successful in attracting and retaining traveling nurses by promoting their culture of support at work, spokesperson Kadie Agnew said.
“Sometimes you have to be creative,” she says. “Some (nurses) decided to stay long term because they liked it here and are really part of the Baptist family.
Right now, the hospital is finding it difficult to staff travel nurses because many have done so well this year they are taking the vacation, Agnew said.
In northern Alabama, where hospitals are experiencing one of the largest increases in COVID-19 cases this month, the Huntsville hospital reports that it is not facing a staff shortage. Near Athens there is a somewhat different story.
At Athens-Limestone Hospital, a 71-bed acute care facility that serves the county just west of Huntsville, there is a relative lull in COVID-19 earlier this month, when 22 patients COVID have been hospitalized.
Traci Collins, interim president and chief nurse, says this week’s tests show cases are on the rise again. She says staff shortages and staff sick with COVID-19 is a double whammy.
And then there’s what she calls “COVID fatigue” for healthcare workers.
“People are really, really tired. She is deteriorating both physically and emotionally, ”she said of the unpredictable course of the disease and the demands of wearing full PPE and giving patients a barrage of drugs and extra oxygen.
“I think it was very difficult for our staff to watch these patients go into bad shape, get better and decline.”
Hospitals will do what is necessary to take care of patients with COVID-19, Williamson said. This may mean redirecting staff from other parts of the hospital to the COVID-19 ward.
He said hospitals were discussing whether and when to suspend elective procedures again, forcing some patients to postpone treatment for chronic and painful health conditions.
For state hospitals already facing financial challenges, repeating such a step represents a big financial loss. The first six weeks of a state-imposed moratorium on elective procedures this spring cost Alabama hospitals $ 739 million, according to Williamson.
However, growing demands of COVID-19 are being addressed, he said, it is inevitable that cases will continue to rise this winter, overtaking the spring outbreak.
“I think it’s almost a given that we’re going to get past our previous worst-case scenario, and we’re going to end up, frankly, with a pretty stressed health care system.
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