Medical workers at Grady Memorial Hospital in Atlanta emerge from the ambulance bay on Tuesday, Aug. 10, 2021. Hospitals throughout the state are diverting ambulances as they have been overwhelmed with COVID-19 patients. (John Spink / [email protected])
By Carrie Teegardin and Yamil Berard
Critical nursing shortage statewide raises concerns about caring for rising patient load
A steep increase in seriously ill COVID-19 patients has pushed hospitals statewide into crisis mode again this week, prompting worries that the new surge may overwhelm facilities already struggling to find enough nurses to adequately staff emergency rooms and intensive care units.
Large hospitals in metro Atlanta frequently went on diversion status this week because they were so full, sending ambulances elsewhere. Some elective procedures started to get pushed back across the state to free up medical staff and hospital beds.
Everywhere, top doctors monitored a trendline driven by the highly contagious delta variant they worry could surpass the January surge that flooded every hospital in Georgia.
Southeast Georgia Health System in Brunswick this week already passed its previous pandemic peak. More than half of its hospitalized patients were sick with COVID-19, and some had to stay in the emergency room for care because the hospital was so full. “Our emergency room wait times have surpassed anything I’ve ever experienced in my medical career,” said Dr. Mohsen Akhlaghi, the system’s chief of emergency medicine.
Statewide, the seven-day rolling average for hospitalizations — 3,214 as of Tuesday — exceeded the peak of last summer’s surge. In five of the state’s 14 hospital regions, fewer than 10 ICU beds were open.
With cases and hospitalizations rising quickly across Georgia, it’s hard for hospitals from one part of the state to help out hospitals elsewhere that are overloaded.
“This is an extraordinary point of the pandemic,” said Dr. Dianna Grant, chief medical officer at the Phoebe Putney Health System in Albany, which was the first in Georgia to be hit hard by COVID-19. “Seventeen months ago, when the Albany area was an early hotspot, we were an outlier. Other hospitals that were not dealing with an onslaught of patients had the ability to help. That’s not the case now. All hospitals are operating at capacity.”
The trendlines suggest that the coming days will further test a healthcare workforce that has already been on the front lines for more than a year.
“This is the most rapid of all the surges,” said Dr. Danny Branstetter, medical director of Infection prevention for the Wellstar Health System. “How far will it go? Will it get to those peak numbers we saw in December or January? Who knows. But the quickness with which it is getting there is of concern today.”
Dr. Robert Jansen, the chief medical officer at Grady Memorial Hospital in Atlanta, also said the rapid rise in cases with this surge is a big concern and reflects how infectious the delta variant of the coronavirus is.
“Our fear is that if it doesn’t slow down it could rapidly exceed the peak we saw in the winter,” he said. Knowing that other spikes followed holidays, Jansen said he was especially concerned about gatherings to mark the end of summer. “If people have big parties over Labor Day, we could see even a further spike that could be devastating to people.”
Urgent need: more nurses
Nurses were in short supply even before the pandemic. Now it’s a crisis with every hospital and nursing home trying to make hires from a very limited pool. Already, hospitals in Albany, Macon and Atlanta have been delaying some elective procedures to cope with the problems.
“Our biggest issue in caring for COVID patients is staff,” said Rebecca Sylvester, a spokesperson for the University Health Care System in Augusta, where the number of COVID-19 patients has increased from 26 to 91 in the last two weeks.
She said that last year the system’s Summerville location helped handle the COVID patient load. “Unfortunately we have not been able to reopen the Summerville inpatient COVID cohort because we aren’t able to staff it appropriately.”
The staffing challenges seem to be greater this time around than with past surges, said Branstetter, with Wellstar. “We have the space, we have the equipment, we have the personal protective equipment, the beds, the ventilators. All those things are available. It is the respiratory therapists, the bedside nurses that we need.”
Jansen, at Grady, said the hospital is able to staff its beds and its ER even though it needs more nurses. “It means the nurses are working much harder,” he said.
The demands are difficult for health care workers who have been dealing with a pandemic for more than a year. “The psychological stress I think right now is as intense as I have seen it,” Jansen said. “People are tired. They are tired of dealing with this now. Everybody wants it to go away and it’s just not going away right now.”
Medical workers arrive Tuesday, Aug. 10, at Grady Memorial Hospital against a large banner draped across the facade of a parking deck. COVID-19 cases are filling Georgia hospitals once again, igniting concerns of even more devastating outbreaks to come. (John Spink / [email protected])
While large hospitals in Atlanta struggle for nurses, rural hospitals often face even greater challenges finding the staff they need. Angela Ammons, CEO of Clinch Memorial Hospital in Homerville, also is a registered nurse. Because of staffing shortages, she is also working on the floor while she serves as CEO. She went to work Tuesday in her scrubs and packed an overnight bag in case she had to stay at the hospital because of the rise in cases.
She said she has been calling an agency that provides nurses to healthcare facilities, but the agencies have no more nurses to send to her.
“If we don’t have enough staff to come in and patients start flooding our ER, we’re not turning them away,” Ammons said. “We will do the best we can. It’s similar to another wartime effort, like what we were in last year. We’re doing the best we can with what we got.”
Staff dismayed by public response
Kerry Trapnell, CEO of Elbert Memorial Hospital in Elberton, said the spike at Athens-area hospitals is spilling over to his small rural hospital. “We’re glad to help larger hospitals, but we’re now at near capacity,” Trapnell said.
Monday, the hospital called 20 other Georgia facilities to try to get a patient with presumed COVID transferred. “No one had an available bed,” Trapnell said. “Finally a bed cleared up … but the patient ended up passing there. It’s sad, and I am not going to imply that the delay cost the patient’s life, but you don’t know. That’s the concern of not being able to transfer patients where they need to go.”
Hospitals around the state pleaded with people to get vaccinated to try to flatten the current curve, trying to make them understand the system that handles every health care problem from strokes to accidents to cancer treatment is hampered when it has more patients than it can handle.
Wait times are longer at almost every emergency room right now, whether it’s a large hospital in Atlanta or a rural hospital in a small town. At Southeast Georgia Health System, the hospital publishes statistics every day showing that the vast majority of hospitalized COVID patients have not been vaccinated.
“It’s very hard, very disheartening for our health care teams to be going through this again. The hardest part is that we aren’t experiencing the community support that was shown last year when there wasn’t a vaccine available,” said Michael D. Scherneck, president and CEO at Southeast Georgia Health System.
He said that while vaccination rates are low in the community, patients are also complaining about long waits for emergency care at the overloaded hospital.
“Our frontline workers are dismayed by the reactions of those who chose not to become vaccinated. We acknowledge that the vaccine is a personal choice, but with that choice comes an obligation to accept the consequences” he said. “We know that everyone wants to move past COVID-19 and certainly none of us thought that we’d be dealing with it for so long. That’s why people need to get their vaccine.”
Read the original story on AJC.com.
