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As the coronavirus pandemic surges across the nation and infections and hospitalizations rise, medical administrators are scrambling to find enough nursing help — especially in rural areas and at small hospitals.Nurses are being trained to provide care in fields where they have limited experience. Hospitals are scaling back services to ensure enough staff to handle critically ill patients. And health systems are turning to short-term travel nurses to help fill the gaps.Adding to the strain, experienced nurses are “burned out with this whole (pandemic)” and some are quitting, said Kevin Fitzpatrick, an emergency room nurse at Hurley Medical Center in Flint, Michigan, where several left just in the past month to work in hospice or home care or at outpatient clinics.“And replacing them is not easy,” Fitzpatrick said.As a result, he said, the ER is operating at about five nurses short of its optimal level at any given time, and each one typically cares for four patients as COVID-19 hospitalizations surge anew. Hospital officials did not respond to requests for comment.But the departures are not surprising, according to experts, considering not only the mental toll but the fact that many nurses trained in acute care are over 50 and at increased risk of complications if they contract COVID-19, while younger nurses often have children or other family to worry about.“Who can actually work and who feels safe working are limited by family obligations to protect their own health,” said Karen Donelan, professor of U.S. health policy at Brandeis University’s Heller School for Social Policy and Management. “All of those things have been factors.”Donelan said there is little data so far on how the pandemic, which has killed more than 231,000 people in the country, is affecting nursing overall. But some hospitals had a shortage even before the virus took hold, despite a national rise in the number of nurses over the past decade.With total confirmed coronavirus cases surpassing 9 million in the U.S. and new daily infections rising in 47 states, the need is only increasing.Wausau, Wisconsin-based Aspirus Health Care is offering ,000 signing bonuses for nurses with at least a year of experience and hiring contract nurses through private staffing companies to handle a surge in hospitalizations that prompted the system to almost quadruple the number of beds dedicated to COVID-19 patients.Aspirus, which operates five hospitals in Wisconsin and four in small communities in Michigan’s Upper Peninsula, also is moving nurses around between departments and facilities as hot spots emerge, said Ruth Risley-Gray, senior vice president and chief nursing officer at Aspirus.Outside help still is needed, in part because some nurses have gotten sick from or were exposed to the cornavirus during the current wave, which “came with a vengeance” starting in August, Risley-Gray said. At one point in mid-October, 215 staffers were in isolation after showing symptoms or being exposed to someone who tested positive, and some are just starting to return to work.Aspirus recently was able to hire 18 nurses from outside agencies, and may need more if the surge continues.Because the pandemic is surging just about everywhere in the country, hospitals nationwide are competing for the same pool of nurses, offering pay ranging from ,500 a week to more than ,000, said April Hansen, executive vice president at San Diego-based Aya Healthcare, which recruits and deploys travel nurses.She said demand for their services has more than doubled since early in the pandemic when the greatest need was in hot spots like New York and New Jersey and then moved to southern states. In recent weeks the virus has been spiking across the country, with the new hot spots in places like the rural upper Midwest and southern-border communities such as El Paso, Texas.Now placing nurses where they’re needed is “like a giant game of whack-a-mole,” said Hansen, whose company has about 20,000 openings for contract nurses.In North Dakota, where infection rates are exploding, hospitals may cut back on elective surgeries and seek government aid to hire more nurses if things get worse, North Dakota Hospital Association president Tim Blasl said.In Texas, Gov. Greg Abbott recently announced he was sending 75 nurses and respiratory therapists to El Paso to help handle the city’s surge. Wisconsin Gov. Tony Evers, meanwhile, issued emergency orders making it easier for nurses from elsewhere to practice in his state and for retired nurses to come back.“This has been a challenge, and we’ve been pleading with the community members to protect themselves and others,” by wearing masks and social distancing, said Aspirus’ Risley-Gray, who said the positivity rate among community members tested by Aspirus rose from under 10% in September to 24% last week.To combat the emotional toll and fatigue that comes with caring for COVID-19 patients, including just donning and removing protective equipment all day, Aspirus has been giving nurses microbreaks and quiet places to get away and collect themselves when they feel overwhelmed.Travel nurses say the need at small hospitals tends to be greater than at larger facilities.Robert Gardner, who’s currently assigned to a hospital in a small town about 20 miles west of Atlanta, said he did search and rescue in the Coast Guard during Hurricane Katrina and the pandemic is “a lot worse.”He worked at a large New Jersey hospital when that state was swamped by the virus in the spring, and now worries that flu season could bring further chaos to hospitals. But he’s determined to stick it out, no matter what.“It’s not even a question,” Gardner said. “Nursing is a calling.” 5727

Attorney General Jeff Sessions pushed back against President Donald Trump's latest insult on Wednesday, prolonging an increasingly awkward public spat between the President and his top law enforcement official.Trump chastised Sessions over an investigation into alleged surveillance abuses, calling his approach "disgraceful.""Why is A.G. Jeff Sessions asking the Inspector General to investigate potentially massive FISA abuse. Will take forever, has no prosecutorial power and already late with reports on Comey etc," Trump wrote. "Isn't the I.G. an Obama guy? Why not use Justice Department lawyers? DISGRACEFUL!"Responding to Trump's tweet, the attorney general said in a statement that the Justice Department "initiated the appropriate process that will ensure complaints against this department will be fully and fairly acted upon if necessary.""As long as I am the attorney general, I will continue to discharge my duties with integrity and honor, and this department will continue to do its work in a fair and impartial manner according to the law and Constitution," Sessions said.Sessions had said Tuesday that the Justice Department is looking at whether the FBI has properly handled applications for surveillance orders under the Foreign Intelligence Surveillance Act.Sessions, appearing at a news conference announcing a new opioid task force, was asked about House Intelligence Chairman Devin Nunes' controversial memo outlining purported surveillance abuses and told reporters that "the inspector general will take that as one of the matters he'll deal with."The Justice Department's inspector general is Michael E. Horowitz, a longtime department official who has worked under Republican and Democrat administrations. He was confirmed for the inspector general job in 2012 under then-President Barack Obama.While Trump is correct that Horowitz does not have prosecutorial powers, he can -- and often does -- make criminal referrals to the Justice Department based on his investigations. An investigation into improper FISA use would fall squarely onto Horowitz, too, given his charge instructs him to "investigate alleged violations of criminal and civil laws by DOJ employee."Sessions chose to respond to the President because his latest jab was more "in the weeds" and about process, said a source familiar with Sessions' thinking.Previous times, Trump has insulted Sessions when calling for the investigation of Hillary Clinton, but this time he called for Sessions to go after Justice Department attorneys, which was a bridge too far, said the source."There is a process, we are following that process," the source added.As Sessions left the Billy Graham event in the Capitol on Wednesday, CNN asked for his response to Trump's tweet and criticism of him."I'm not commenting on that this morning. Thank you," he responded.Asked if he has discussed the criticism directly with the President, Sessions just said, "Thanks."Latest attack on Sessions 2972

As the saying goes, beauty is in the eye of the beholder. And when it comes to appreciating art, that may be more true than ever. It's so subjective and comes down to true appreciation. One woman understands that more than most.To Myrna Hayutin the photos on her gallery wall are more than pictures of the past. She points out some of the art on display.  "This is a limited edition signed by Carl Mydans," Hayutin said. "This is Babe Ruth the last time he put on his uniform."These are works of art."It is history," Hayutin said. "It's just knowledge."And for the last 35 years she's been selling fine art like these pieces, despite the fact that she's legally blind."I anticipate doing this for at least another 10 years," Hayutin said. "As long as my eyesight holds."Hayutin started losing her eyesight when she was eight due to retinitis pigmentosa. And over the years, it's gotten progressively worse."It's like an island," Hayutin said. "As the disease progresses the island gets smaller and smaller now I see through two straws. So you may be standing right here but I am not seeing you. Or if were talking and you move I'll lose you."Still it hasn't affected her love for art or her determination to purse it as a career."It never occurred to me to stop me from doing anything that I really wanted to do," Hayutin said.Hayutin runs a successful international fine art gallery, Gallery M, and recently became an art appraiser."I'm looking at the artwork but honestly thank goodness with my devices I can really zoom in and see them much, much better," Hayutin said.Hayutin said her dog, Gouda, helps her navigate the changes in her eyesight, but what helps most is not focusing on what could happen."I would never have opened the gallery if I was fearful of what would be instead of what was at that time," Hayutin said. "I try to live in today and use the eyesight that I have today."Hayutin said every day is what you make it."There are some days where I'm not as positive as I should be, but I try it," Hauytin said. "I try to get back on that positive I mean because I'm surrounded by all of this gorgeous art and that's very uplifting."  2212

ATLANTA (AP) — The shooting death of an 8-year-old girl has prompted a ,000 reward for information as authorities in Atlanta search for at least two people who opened fire on the car she was riding in. Police identified the girl as Secoriea Turner, and say she was in a car whose driver tried to get through an illegal barricade placed near Wendy's restaurant where Rayshard Brooks was killed by a white police officer on June 12. In a news conference on Sunday, Atlanta Mayor Keisha Lance Bottoms said "enough is enough" and asked for the public's help in identifying the shooter. 592

Attorney General Jeff Sessions ordered a review Friday into how the Justice Department and FBI respond to indications of potential violence after the bureau said it failed to act on a tip about the shooter in the Parkland, Florida, school massacre.A person close to Nikolas Cruz, the confessed shooter, contacted the FBI on January 5 to report concerns about him, the FBI said in a statement Friday. But the bureau did not appropriately follow established protocols in following up on the tip."The information was not provided to the Miami Field Office, and no further investigation was conducted at that time," the statement said.The stunning admission -- which prompted Florida Gov. Rick Scott to call on FBI Director Christopher Wray to resign -- is sure to raise further questions about whether the FBI could have prevented the shooting at Marjory Stoneman Douglas High School, which left 17 dead.  915

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