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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

BAKERSFIELD, Calif. (KGTV) — A man accused of boarding a Greyhound bus in San Diego before opening fire and killing one person in the Los Angeles area pleaded not guilty in court.Anthony Devonte Williams, 33, of Capital Heights, Md., pleaded not guilty to one count of first-degree murder and five counts of attempted murder.Williams is accused of opening fire on a bus as it was traveling on Interstate 5 between Los Angeles and Bakersfield on Feb. 3. He reportedly first boarded a bus from San Diego to Los Angeles before boarding another bus in Los Angeles heading to San Francisco.Passengers say Williams was cursing and muttering incoherently before opening fire.The shooting killed 51-year-old Lurbis Elena Vence, of Molino, Colombia, according to KERO., and injured five other people.Other passengers were able to disarm Williams and forced him off the bus. 872

At least 18 people have been killed and 178 others injured after a train derailed in Yilan County in northeastern Taiwan, according to an update from the island's transport ministry.Initially, the ministry said 22 people died, but it later revised the number.The train was traveling between the cities of Shulin and Taitung when it derailed Sunday on a coastal line reportedly popular with tourists.The train was carrying 366 passengers when the accident occurred just before 5 pm local time, the transport ministry said. 529

At least 2.4 million more Americans were impacted by an Equifax data breach that happened last year, though those customers had less data stolen.The Associated Press reported the newly announced customers had only their names and a partial driver's license number stolen. The original data breach involved 145.5 million Americans who had their Social Security numbers impacted.In the driver's license theft, the attackers were unable to get the state where the license was issued and the dates of issuance and expiration. 529

AUSTIN, Texas — For Brett Hagler, the co-founder of non-profit New Story, building homes for people without adequate shelter is nothing new."We get a large piece of land and work with families that have been living in shacks or tents without shelter and design a totally new community with the families.”Approximately one billion of the world’s population is without proper shelter.To make a dent in that he says, they have to think outside the mold.“We believe traditional ways cannot get us there.”So for New Story’s next endeavor—adding more communities to the land they’ve already acquired in El Salvador—they teamed up with a brand new startup.That’s where Evan Loomis comes in. He’s the co-founder of Austin, Texas-based Icon, a company focused on new technologies for building homes.Their first big debut came at this year’s South by Southwest festival in their hometown.“This is a gigantic robot,” Loomis says, gesturing toward a large steel frame on wheels. “[It] really does some amazing things. Down to the millimeter it knows exactly where to place building materials.”In this case that material is a proprietary mixture of concrete, that pours out of a nozzle on the underside of the metalwork. And the machine moves along a computerized map to create a house.“This is basically the first permitted 3D printed house in the United States,” he said.“We have to invest in [research and design],” Hagler said. “[We asked ourselves] ‘how do we get a breakthrough in cost, speed, and quality?’ And that’s how we landed upon 3D-home printing. The excitement in the air is palpable as they walk us through and around this modest home built up of about 100 one-inch thick concrete layers.“It’s stronger than regular cinder block,” Hagler said. It also comes at a fraction of the cost of a regular house. This model had a price tag of about ,000 but they hope to get the price down to ,000.“We can build in a fraction of the time [compared to traditional construction methods], and it can have a higher quality, strength, and sustainability for the environment."It was 'printed' in just 48 hours. Eventually, they say it will be done in just a half day. It’s a small but open floor plan — with no physical doors — and rooms are separated by partial walls made up of the printed concrete.They say they’ll easily be able to customize different designs.The prototype home can fit a family of four or five.“If you’re coming from a tent or shack and you move into this,” Hagler said, “it’s a significant life-changing difference.”One of the things they’re most excited about with their upcoming 3D-homes project in El Salvador is the fact that they’re introducing groundbreaking technology to the people who usually see tech advances last.“We are actually bringing them the future -- which is robotic construction of housing — first,” Hagler said. “And they’re really excited about that.”They say they plan to begin construction in El Salvador before the end of the year with the hopes of finishing their first community of homes by early 2019. There could one day be plans for 3D printed homes in some of the poorest areas of the United States as well, Loomis said, but he has his eye set on possibly expanding to terrain that’s literally out of this world.“It could be a really great solution for making space habitation a lot more achievable,” Loomis said. “We hit a nerve with this technology, and we are going to hit the gas hard and try to take it to everybody now.” 3528

来源：资阳报