‘No one is applying': Omicron pushes understaffed hospital system into crisis mode

by Sara DiNatale, Mississippi Today
January 11, 2022

The omicron variant is pushing already strapped Mississippi hospitals across the state to their limits, as health care workers attempt to treat a growing volume of patients despite having record low numbers of nurses on staff.

Most, if not all, hospitals across the state were at or near their capacities as of Tuesday morning, according to a University of Mississippi Medical Center administrator. 

On Monday night, a Pascagoula hospital accepted a patient from more than 200 miles away in Yazoo City. The patient had to be flown in by helicopter because of a hole in the wall of his stomach.

“They called 27 other hospitals,” said Lee Bond, CEO of the Gulf Coast's Singing River Health System.

Mississippi hospitals have about 3,000 total nursing vacancies, according to a recent survey by the Mississippi Hospital Association. As a result of shortage and new complications from the latest COVID-19 variant, hospitals have been forced to cut capacities by closing beds and are now triaging patients across the state to get the care they need — omicron-related or not. 

“The game has changed since the delta wave,” Dr. Alan Jones, chancellor of affairs at UMMC said during a Tuesday press conference. “The challenges we are facing are really around staffing. Compounding that is that this is a much more infectious variant, taking more staff out that we have in the workforce.” 

While patients are, in general, experiencing less severe symptoms, there are a higher number of patients coming into hospital than during the last surge in the fall. 

The state's hospital workforce scraped by during the influx of patients brought on by the delta variant, largely because of hundreds of federally-funded nurses that came in to supplement care. 

“Resources are tight throughout the country, especially in nursing,” Jim Craig, the director of the Mississippi Department of Health, said last week. “I don't know that we are going to be able to draw in the type of staffing levels we saw during delta right now.” 

Even if hospitals could get that help again, Jones said it likely wouldn't arrive fast enough, given how quickly the new variant will peak. 

That leaves the state's already diminished number of hospital workers on their own. The state health department has activated a “Mississippi COVID System of Care Plan” until Jan. 23 that requires every hospital to participate in transferring patients so no one center is overburdened.

The system is being used not just to transfer patients with COVID-19 on ventilators, but those in need of life-saving care following car accidents, heart attacks, strokes and organ transplants.

Mississippi hospitals have been hemorrhaging health care workers, especially nurses, throughout the pandemic to better paying jobs with temp companies or out-of-state hospitals. Many burnt out nurses have also opted for retirement. 

The state hospital association's survey, which was taken in December, shows that about one-fifth of the state's nursing workforce is missing from inside hospitals.  

“That's not even factoring in those who are out sick,” said Kim Hoover, a registered nurse with the hospital association. “You have nursing supervisors who come into work Monday morning and find out six ICU nurses are exposed and literally, as of that morning, can't take patients now. It's so fluid it changes from shift to shift.” 

At the University of Mississippi Medical Center, the state's biggest hospital, about 90 health care workers have been out each day because they have contracted the virus. Each day, an average of 175 ask to be tested because they're worried they could be infected — that's triple the number who asked to be tested during the worst of the delta wave, Jones said. 

UMMC is trying to fill 360 registered nurse positions. As of Tuesday, just under 60 beds at the hospital were closed because of staffing shortages. About 25 patients who should have been admitted into the hospital were waiting in the emergency room for a staffed bed to open. 

Singing River Health System's three Gulf Coast hospitals were nearing 100% of their limited capacity at the start of the week. They have had to cut back their bed capacity by nearly one-third because of staffing shortages caused both by vacancies and sick workers. 

The hospital has been desperately trying to fill more than 200 nursing jobs for months.

“No one is applying,” said Sarah Duffey, a Singing River spokeswoman. 

The nursing shortage was an issue before the pandemic, but has been exasperated by the virus's pressure on the American health care system.

Nurses have been leaving Mississippi hospital jobs to take on lucrative temporary positions, commonly called travel nurse jobs. Travel nurses are often paid three to four times as much as what local healthcare workers are paid for the same jobs in Mississippi hospitals. 

Hospitals nationwide use the temp companies as a short-term fix to filling holes in care, meaning the demand for them is at all-time highs. 

READ MORE: Nurses beg Gov. Tate Reeves to act as they face statewide hospital staffing crisis

During the delta wave, 900 temporary nurses from travel companies came to Mississippi hospitals. Those contracts totaled $144 million, paid by federal money through the state emergency management agency. 

Bond, the Singing River CEO, has been vocal about using federal funds to create a nurse retention program. He said he would like to see that kind of money committed to such a program to keep nurses from leaving Mississippi.

Ideally, he says, the state Legislature would use $400 million of the $1.8 billion of American Rescue Plan funds received by Mississippi to create a retention program for the most in-demand health care workers. It would result in $20,000 bonuses per person that would pay out over two-year commitments. The bonuses would make Mississippi hospitals more competitive while the labor market for health care workers is tight. 

Sen. John Polk, a Republican from Hattiesburg who chairs the committee tasked with allocating these ARP funds, said the group has nothing “set in stone” and hopes to complete spending recommendations soon. 

In the fall, state leaders discussed creating a plan that would cost $56 million and give bonuses up to $5,000 for the most in-demand health care workers that agreed to stay for a period of five months. Gov. Tate Reeves never called the special session needed to act, so the plan never materialized. 

Bond says that amount is not enough to actually change course for Mississippi's staffing emergency. 

“Omicron is not our primary problem,” Bond said. “Our primary problem is that going into it, we were already short for heart attacks, strokes, car accidents and the many other maladies that Mississippi needs nurses to be able to take of.” 

Before the virus ever spread, Mississippi already projected it would need 2,100 new nurses each year. 

“The fact is there are significantly less nurses in Mississippi now than before the pandemic, there are less enrolled in nursing school and there are few reasons for that to change,” Bond said. “We expect this will lead to a more dire situation over the next year and a half regardless of any viruses.”

READ MORE: A new hospital crisis: Mississippi loses hundreds of nurses

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.