胆囊结石可以自己排出来吗重庆(肾结石2.2cm需要进行手术吗?重庆) (今日更新中)

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

ATLANTA — Leading congressional Democrats are reacting furiously to lightly-substantiated claims that immigrants held at a detention center in Georgia are undergoing questionable hysterectomies.In a complaint filed Monday, a nurse alleges that the Irwin County Detention Center performed questionable hysterectomies, refused to test detainees for COVID-19 and shredded medical records.Democrats seized on the most explosive allegations in her complaint, that a gynecologist called the “uterus collector” was performing “mass hysterectomies.”A top medical official with U.S. Immigration and Customs Enforcement released a statement “vehemently” disputing the claims, according to the Washington Post, saying only two women have been referred for hysterectomies from the facility since 2018.A follow-up news conference Tuesday in Atlanta provided little information to substantiate the claims. The nurse, Dawn Wooten, and her lawyers refused to release her full statement made to the Department of Homeland Security’s Inspector General. She also declined to take questions after making comments to the media.Wooten worked full-time as a licensed practical nurse at the immigration detention facility until July, when she was demoted. She had missed some work because she had coronavirus symptoms, according to NBC. Wooten says she was demoted because she asked her superiors about the lack of COVID-19 testing and PPE at the facility.The gynecologist is not named in Wooten’s whistleblower complaint. Multiple media outlets report women from the facility have been taken to a local doctor named Dr. Mahendra Amin.Scott Grubman, a lawyer for Amin, said in a statement to the Washington Post that he was confident the doctor would be cleared of any wrongdoing.“Dr. Amin is a highly respected physician who has dedicated his adult life to treating a high-risk, underserved population in rural Georgia,” Grubman said.Amin has previously been accused by state and federal authorities of falsely billing Medicare and Medicaid in an investigation that ultimately led to a 0,000 settlement in 2015, according to the Department of Justice.“If true, the appalling conditions described in the whistleblower complaint – including allegations of mass hysterectomies being performed on vulnerable immigrant women – are a staggering abuse of human rights,” House Speaker Nancy Pelosi, a California Democrat, said in a statement. 2422

As wildfires rage in California, emotions are heating up.“People are not getting along,” said Boulder Creek, California, local Alex.In the Santa Cruz mountains, people are stocking up on gas but running out of patience.“The whole valley was closed,” Alex said. “Closed man!”At the local grocery store, workers are counting every single cent after being shut down for two weeks due to fire concerns.“We definitely have stocked up on our gallon waters,” said Vanessa Russo, owner of Wild Roots Market in Boulder Creek.Russo says wildfires during the pandemic have drastically cut into profits and are now weighing on people’s wallets and their well-being.“A lot of our customers are having to deal with refrigeration issues and slowly having evacuations be lifted,” she said.With thousands of homes destroyed during these fires and many businesses already suffering due to COVID-19 concerns, rebuilding could come at a cost never seen before.“The 2020 fire could be even more catastrophic than say the 2018, which was I think was billion,” said Janet Ruiz with the Insurance Information Institute.Ruiz says the California fires could impact areas across the country.“Agriculture, you talk about the wine industry,” she said. “Beef, the pork, all those could be affected by catastrophe.”The economic impacts of these fires stretch from the mountains, all the way to the ocean“So, the time when our businesses need funding from us, we don’t have it to give,” said Bonnie Lipsco-mb, director of economic development for the City of Santa Cruz.Fire displaced Lipscomb’s family and they’re now living in a trailer.”Despite the new digs, Lipscomb is still focused on helping her community during these unprecedented times.“The impact is really catastrophic,” she said. “I don’t think we’ve seen this since the earthquake and maybe not even then.”With much of the city’s budget funded through sales and property taxes, areas of income that were already suffering before the fires, city leaders are now seeking support from state and federal government agencies.“We’re working on long-term recovery, but at the same time, it's day by day,” Lipscomb said.That road to economic recovery, however, will be long and costly. 2221

At the Jupiter Inlet in Florida on Sunday, a young girl was swept off the jetty and into the water by a fierce wave.Tom Gaffney shot video of the incident at 9 a.m.Video shows a strong wave crash into the little girl, forcing her under the guardrail and into the sea.People quickly rushed in to pull her from the water. She suffered a cut to the head, along with some scrapes and bruises but is expected to be OK.   448

Authorities asked for the public's help Wednesday in identifying a woman who allegedly broke into an Irvine home and went into a resident's bedroom before being chased out by a resident.Surveillance video captured the woman ringing the doorbell of a residence on Jan. 18 at 8:34 p.m., Irvine, California police said.The homeowner — who did not want her name made public — said when nobody came to the door, the intruder made her way into the house via a side door and then into the upstairs bedroom where the homeowner's college-age daughter was sleeping.The daughter woke up and asked the intruder who she was, the family said. The trespasser managed to flee after the daughter chased her out of the house, according to the mother.After reviewing surveillance footage, the family said they discovered that the intruder had also come to the home in December. It's unclear whether she was able to enter the house at that time.The family said they did not know the woman, who was described by police as Asian with brown hair, brown eyes and of average height. The family has changed the locks on their home.Anyone with information can call Irvine Police Department Detective Matt Ricci at 949-724-7189 or email mricci@cityofirvine.org. 1261

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