California desperately searches for more nurses and doctors

Since coronavirus pandemic took hold in U.S., Sara Houze has been on ro — going from one hospital to ar to care for COVID-19 patients on brink of death. A cardiac intensive care nurse from Washington, D.C., with expertise in heart rhythm, airway and pain manment, her skills are in great demand as infections and hospitalizations skyrocket nationwide. Houze is among more than 500 nurses, doctors and or medical staff California has brought in and deployed to hospitals that are running out of capacity to treat most severe COVID-19 cases.

Her six-week assignment started Monday in San Bernardi, about 60 miles (97 kilometers) east of Los Angeles, and she anticipates working 14-hour shifts with a higher-than-usual caselo. San Bernardi County has 1,545 people in hospitals and more than 125 are in makeshift “surge" beds, which are being used because regular hospital isn't available.

“I expect patients to die. That’s been my experience: y die, I put m in body bags, room gets cleaned and n ar patient comes,” Houze said.

Much of California has exhausted its usual ability to staff intensive care beds, and nation's most populated state is desperately searching for 3,000 temporary medical workers to meet demand. State officials are reaching out to foreign partners in places like Australia and Taiwan amid a short of temporary medical workers in U.S., particularly nurses trained in critical care. Gov. Gavin Newsom said state has relationships with countries that provide aid during crises such as wildfires.

“We’re w in a situation where we have surges all across country, so body has many nurses to spare,” said Dr. Janet Coffman, a professor of public policy at University of California, San Francisco.

California hospitals typically turn to staffing ncies during flu season, when y rely on travel nurses to meet patient care needs. It is only state in nation with strict nurse-to-patient ratios requiring hospitals to provide one nurse for every two patients in intensive care and one nurse for every four patients in emergency rooms, for example. However, those ratio requirements are being waived at many hospitals as virus cases surge.

But pool of available travel nurses is drying up as demand for m jumped to 44% over last month, with California, Texas, Florida, New York and Minnesota requesting most extra staff, according to San Diego-based health care staffing firm Aya Healthcare. It is one of two companies contracted by California to fulfill hospitals' staffing requests.

“We are hiring like crazy and working insane hours,” said Sophia Morris, vice president of account manment at Aya Healthcare.

Dr. Mark Ghaly, California's Health and Human Services secretary, said state is “lucky to get two-thirds” of its requests for travel nurses fulfilled right w. It's a sharp contrast from spring, when Newsom ordered nation's first stay-at-home order. As infection rates slowed and hospitals voluntarily suspended elective surgeries for weeks, health care providers from California flew to New York to help ir overworked colleagues.

This time, many hospitals are postponing procedures that are t emergencies, said Jan Emerson-Shea, a spokeswoman for California Hospital Association. California also has opened alternative care facilities for people with less serious illnesses to save hospital beds for sickest patients. That also means hospitals have fewer nurses to deploy to ICUs from or units, Coffman said. And many health workers became infected or have h to quarantine because y were exposed to someone with COVID-19 during surge, she said.

Ar factor is dip in number of nurses 60 and older. In a survey of state's 320,000 registered nurses, many older nurses told researchers at UCSF's Healthforce Center that y stopped working out of concern for ir or ir family’s health, said Joanne Spetz, center's associate director of research.

Houze, 50, said she's able to travel to work because her twin sons are in college but t without contracting a mild case of COVID-19 somewhere along way. On Monday, more than 17,000 people were hospitalized with confirmed COVID-19 infections more than double previous peak reached in July and a state model that uses current data to forecast future trends shows number could reach nearly 100,000 by January. More than 3,600 COVID-19 patients were in intensive care units.

Dr. Marc Futernick, an emergency room physician in Los Angeles who is on board of California chapter of American College of Emergency Physicians, helped set up a Los Angeles surge hospital last spring. w, he's fielding texts and phone calls asking when it will reopen.

“ surge hospital is t going to open again. re would be way to staff it,” he said.

Ghaly, he of state Health and Human Services, said entire areas of California may run out of room even in surge capacity units “by end of month and early in January.” It's trying to avoid that by opening makeshift hospitals in places like gymnasiums, tents and a vacant NBA arena, and sending patients to parts of state with empty beds.

Newsom this spring sought to reinforce fatigued medical workers by creating a paid volunteer California Health Corps, and he touted many thousands who signed up. But with cases skyrocketing w, just 28 members are working at 13 facilities. number has dwindled even after Newsom me repeated appeals for more retired medical professionals to sign up. state is updating its planning guide for how hospitals would ration care if everyone can’t get treatment y need.

A document recently circulated among doctors at four hospitals run by Los Angeles County calls for m to shift strategy: inste of trying everything to save a life, ir goal during crisis is to save as many patients as possible. That means those less likely to survive won’t get same kind of care offered in rmal times.

Houze said her online community of nurses is offering webinars about moral distress because many of m have h to change way y care for patients. “ patients that aren't yet intubated, and even ones intubated, aren't getting kind of nursing care that I want to give m because our resources are so limited and time is taxed,” she said. “It's really disheartening.” 

(Im Credits: AP)