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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

As summer winds down, doctors across the country are warning flu season is fast approaching. Many are watching Australia to see what may happen here when flu season arrives."Where Australia is obviously in the Southern Hemisphere, they're in winter while we’re in summer. We look at their flu season as kind of a six-month predictor of how ours is going to turn out," says Dr. Kenny Banh, the assistant dean of undergraduate medical education at UCSF-Fresno.The number of flu cases in Australia has taken a dramatic dip compared to last year. Dr. Banh says it's unclear if the U.S.'s flu rates will be as low as Australia's.A lot of it has to do with coronavirus precautions that people are taking, Banh hypothesizes."That's what we predict. It's not really so much a change in vaccination rates as much as the social distancing and all the preventative steps of coronavirus that are having the same effect of spreading any disease, including influenza," says Dr. Banh.Doctors say strict measures in Australia to protect people from COVID-19, such as physical distancing, wearing masks and hand washing, have helped prevent the spread of the virus and, incidentally, the flu. Now, some are wondering whether the United States will also see a drop in flu cases this winter."Seeing that they have a drop in influenza, we will certainly have a small influenza season. The issue is Australia is approaching, and the U.S. is approaching coronavirus very different. Their rates are different and they have a much lower per capita infection rate than we have in the U.S. for various reasons," says Dr. Banh.Australia has taken a broader, nationwide approach to protecting people against COVID-19, unlike in the United States, where each state has implemented different restrictions. That's one reason why Dr. Tanya Altmann with the American Academy of Pediatrics recommends every person, 6 months of age and older, gets a flu vaccine."I think this winter, it may be hard to differentiate between the flu and COVID-19 because so many of the symptoms-- cough, fever, aches, chills, are very similar. So by getting the flu vaccine and decreasing the chance your child has influenza, that will help us figure it out," says Dr. Altmann.Dr. Banh says Australia's plummeting flu rates and nationwide protective measures from COVID-19 will hopefully encourage many here in the United States to take the necessary precautions to keep everyone as healthy as possible this winter. 2470

As the US federal government was set to run out of funding at the end of Friday, the House of Representatives and Senate both passed H.J.Res. 107 on Friday, which funds the government through Sunday night. Without approval, the federal government would have entered a shutdown on Saturday.The measure passed through the House by a 320-60 margin. Less than an hour later, the Senate approved the bill by a voice vote. President Donald Trump then signed the bill late Friday night, officially keeping the government open this weekend.Without funding, essential federal government employees would work without pay. Other government employees would be told to stay home.The discussion on funding the government comes as House and Senate leaders are still working on a compromise on a stimulus package. Both sides have stated that legislators won’t leave Washington without approval of a pandemic relief package. House Majority Leader Steny Hoyer said congressional leaders will continue discussing a stimulus package over the weekend, but no votes will be called before Sunday afternoon. As of now, 0 stimulus checks are in the pandemic relief proposal.The pandemic relief bill would also include supplemental funds for unemployment, and adding money to the Paycheck Protection Program, which helped businesses make payroll early in the pandemic. 1353

As millions of Americans have been without work amid the pandemic, nearly 12 million people will lose unemployment benefits on December 26, according to the Century Foundation.The Century Foundation estimates that 7.3 million Americans will exhaust benefits from the Pandemic Unemployment Assistance program. The federal program extended unemployment benefits for millions of Americans who otherwise would not have received state unemployment benefits.According to the Century Foundation, 4.6 million Americans will lose benefits through the Pandemic Emergency Unemployment Compensation program on December 26. This fund extended state unemployment benefits for an additional 13 weeks. The 4.6 million Americans is in addition to the 3.5 million workers who will have lost PEUC benefits by then.“Congress has stared down major expirations of jobless benefits multiple times during the Great Recession and previous economic cycles,” the Century Foundation said. “Policy makers have been more comfortable with enacting temporary extended benefits programs with more predictable costs rather than improving the automatic stabilizers in (extended benefits) EB."While millions of Americans are set to lose benefits, there remains ongoing debate on Capitol Hill to provide some form of economic stimulus. There have been various proposals that would offer extended benefits, but the House, Senate and White House have struggled to find any sort of agreement.“With the stakes of the benefit cutoff perhaps higher than they have ever been before, there also seems to be a grave danger that unemployed Americans could be left behind during a lame duck session taking place in the overhang of a contested presidential election,” the Century Foundation said. “But the numbers—and families behind them—leave no excuses for inaction.” 1829

As the nationwide unemployment rate continues to sit in unprecedented territory, the dramatic job loss numbers also mean millions of Americans have suddenly found themselves without health insurance.Experts call it a cruel twist during the pandemic, meaning many people who get sick with COVID-19 may not get the health care help they need because they don’t have coverage.“We have massive numbers of people who are worried about their health but who no longer have coverage,” said Michelle Johnson, who oversees the nonprofit Tennessee Justice Center.Johnson says calls to her organization have increased dramatically in the last few months as Americans are finding themselves uninsured after losing their jobs due to COVID-19.“We’re just going to continue seeing people who are losing their insurance,” she said.According to the Kaiser Family Foundation, nearly 27 million people in the United States may have lost employer-sponsored insurance. Roughly half of Americans receive health insurance through their jobs. And while programs like COBRA allow people who have been laid off to continue their coverage, many can’t afford to pay those costs with no income.Johnson says the problem is particularly troubling in state’s like hers where Medicaid expansion already meant there were hundreds of thousands of residents who were uninsured.She hopes the federal government might consider opening enrollment in the Affordable Care Act to help those who have suddenly lost coverage.Johnson’s biggest concern though, is the consequences may prove deadly as those without coverage now avoid trips to the doctor or emergency room for fear of getting stuck with bills they can’t afford.“People will delay getting the care they need because they’re worried about being a financial burden,” said Johnson. 1804