Patients Drive Hours to ERs as Omicron Variant Overwhelms Rural Hospitals

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Hospitals recall staff with Covid-19 to work to handle rush of patients in some parts of the country

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The rise of the highly infectious Omicron variant is prompting healthcare workers to take drastic measures to prevent care failures. Although Omicron may cause less severe disease than earlier variants, research has shown, the number of people experiencing severe cases of COVID-19 has increased since infection rates surpassed previous pandemic peaks. . The US this past week reached the highest recorded level of hospitalized patients with both confirmed and suspected Covid-19 cases.

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In rural America, the problem is worse. One or two missing workers can shut down the entire clinic. Now many people are sick with Omicron. Many rural facilities say they cannot afford to hire travel nurses at rates that have skyrocketed during the pandemic. And some clinics and family practices that typically provide care that could prevent people from landing in hospitals are closing because Omicron has also laid off its workforce.

Rural hospitals are using veterans groups and foreign nurses to increase staffing. Some are recruiting non-vaccinated workers who were fired elsewhere for failing to comply with the mandate to get the shots. And some hospitals are asking employees with COVID-19 to keep working.

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“We really feel we have an imminent medical crisis here,” said Teresa Tyson, nurse practitioner and executive director of Health Wagon, a nonprofit clinic that offers free healthcare in Appalachian Virginia.

To keep people away from the hospital, Health Wagon was treating people suffering from Kovid-19 with monoclonal antibodies. Now they are supplying rations for treatment, making it more likely that some will require hospitalization, Ms Tyson said.

“We’ve had to do this job, where we take this 78-year-old cancer patient over someone we think might better weather Covid,” she said.

Sanford Health, a hospital system that serves remote parts of the Dakota, Minnesota and Iowa, began in late 2020 to recruit nurses from overseas to ease staffing shortages that worsened during the pandemic. . Sanford aims to persuade 700 nurses from countries including the Philippines, Nigeria, Brazil and India to move on by 2024. The system plans to connect them with employees who can help them navigate the harsh winters and other peculiarities of life in the Dakota. The first eight nurses are due to arrive in Fargo, ND this quarter.

Sanford said hundreds of its 34,000 employees are sick with COVID-19 and hundreds more are awaiting test results. One of the system’s critical-access hospitals has been closed after all four of its nurses became ill with Covid-19. As a result some patients spend two or three hours driving to the nearest ER. Sanford is considering cutting down on non-essential services and elective surgeries. It has asked asymptomatic and Covid-19-positive employees who no longer feel sick to return to work after five days.

“This is an urgent situation,” said Sanford chief nursing officer Erica DeBoer.

Recruitment, often difficult for employers in remote areas, has been tough during the pandemic. Some recruiters are trying to attract nurses to far-flung areas for little money by praising the area’s natural beauty and promise of entertainment and adventure.

Justin Jacob, a recruiter and former ICU and ER travel nurse at Unity Med Partners, recently held a nurse in Sitka, Alaska, saying that when she nearly got burned, the state renewed her love for people and nursing. . Mr Jacob said he sold the nurse when he went there for fishing, hiking, whale watching and crabbing.

Grant Studebaker, an assistant professor at the University of Tennessee and a family medicine doctor at West Tennessee Healthcare, said he recently took a detour to a clinic to find a parking lot full of patients. The clinic in Jackson, Tenn., had reverted to offering primary care from COVID-19 care during a delta variant wave, before returning to treat COVID-19 patients specifically during the Omicron surge. Several employees were sick, and a nursing supervisor was pitching in to run the lab.

“You know a pulmonologist by chance?” He asked. He said many local pulmonologists have left or retired in recent years and have not been replaced. General practitioners and medical residents now manage complex pulmonary problems and ICU patients, Dr. Studebaker said.

West Tennessee Healthcare is freeing up staff by letting some patients remotely monitor their own vitals. It’s also getting patients to do their own oxygen treatments.

“When that hospital becomes stressful, it puts a lot of people in this community in a really bad situation,” said Leah Gilliam, a family physician in nearby Lexington, Tenn.

Dr. Gilliam is observing patients with symptoms of COVID-19 during the Omicron wave, fearing that she might bring the virus home to her newborn. He said that the influx of patients has increased significantly. But for many people, that is the only option.

“If I put them away, what am I going to do?” he said. “I don’t want them to go to the emergency department. They’re full.”

Write Julie Vernau at [email protected]

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