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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

At least five people have been killed in a ferocious storm that hammered the Northeast with powerful winds, relentless rain and historic flooding.The nor'easter moved out to sea Saturday, but not before it knocked out power -- perhaps for days -- to more than 900,000 customers from the mid-Atlantic to New England."People in these homes need to plan for a prolonged outage," Kurt Schwartz, director of the Massachusetts Emergency Management Agency, said Friday night. "This is a multi-day restoration event."RELATED:?'Bomb cyclone' pounds east coast with heavy flooding, high winds   The flooding is "the worst that we've seen in years," said Capt. John Dougan of the Quincy, Massachusetts Police Department, which had carried out more than 250 rescues between 8 a.m. Friday and midmorning Saturday. "We're seeing homes underwater, their basements were flooded out, the electricity was off."Emergency officials urged residents on higher ground to stay indoors, even after the storm pushed out."This is not a time to be out sightseeing and gawking, so please stay at home and stay out of our way," James Boudreau, the town administrator for Scituate, Massachusetts, said Saturday.Some 19 million people were still under a coastal flooding warning early Saturday afternoon.The storm morphed Friday into a "bomb cyclone" after undergoing a rapid pressure drop known as bombogenesis. It slammed much of the Northeast with heavy snow and rain, prompting significant coastal flooding and hurricane-force gusts in New England.Winds along parts of the Massachusetts coast that whipped in excess of 90 miles per hour are due to ease Saturday, CNN forecasters said.The storm also dumped heavy snow from Ohio to New England and into upstate New York, where more than 3 feet was recorded.Weak phone connection? Click here to read text-only versions of CNN's top stories.Latest developments? Power outages: More than 900,000 customers were without power Saturday from Virginia to Massachusetts.? Aftermath response: The governors of Maryland and Virginia issued emergency declarations, allowing state and local agencies to help those affected.? Flight cancellations: About 250 flights in the storm zone were canceled Saturday, according to the flight-tracking website FlightAware.com. That compares with more than 3,000 US flights scratched Friday, most at the busiest Northeast airports in Boston, Philadelphia and New York.? Amtrak back in service: Amtrak resumed modified service at 6:20 a.m. ET Saturday, on its Northeast Corridor between Washington and New York, and planned to resume service between New York and Boston beginning at 8:40 a.m., the provider said.Five killed by falling treesAt least five people died in the storm, all killed by falling trees, authorities said. They include: a 77-year-old woman in Kingsville, Maryland; an 11-year-old boy in Putnam County, New York; a 44-year-old man in James City County, Virginia; a 6-year-old in Chesterfield County, Virginia; and a Newport, Rhode Island, man in his 70s.The 11-year-old was in his home when a large tree came crashing down, trapping him. A responding deputy tried to free the boy, whose mother was taken to hospital.Another young boy, just 6 years old, suffered a similar fate when a tree fell through his Virginia mobile home as he was sleeping on a top bunk bed. The boy was rushed to hospital, but his mother told the station his organs were failing."Doctors say we have to let him go," she told CNN affiliate WRIC. Cynthia Creighton's son was in her car when a neighbor's tree fell on top of the vehicle in Watertown, Massachusetts."The house shook, and we heard a noise. We didn't know what it was," Creighton told CNN affiliate WHDH. "We ran out, my son was still in the car with the tree on top of it."Creighton's son, who was in the back seat, was not injured, she said.Boston under waterHigh tides on Friday powered coastal flooding in Boston and other parts of Massachusetts, leaving streets awash for the second time since a massive nor'easter in early January.Kayakers paddled down Boston streets and National Guard members rescued 50 people from their homes in nearby Quincy, sometimes carrying them to safety in the scoopers of front-end loaders, CNN affiliate WBZ reported.Boston Harbor has only seen tides above 15 feet twice -- in 1978 and in January, during the last bomb cyclone. A high tide late Friday morning came up a little short, reaching 14.67 feet, but still sent water sloshing through the streets of East Boston.More record-setting high tides might strike Boston Harbor on Saturday during the midday high tide.With the moon full, the tide is at its highest point of the month, and the storm surge could drive as much as 4 feet of water into coastal neighborhoods, CNN meteorologists said. Massachusetts emergency officials said tides "will be astronomically high" in the next few days."I encourage all residents to be mindful of the storm and encourage employers to take the weather into consideration, which will mostly impact the coastal areas of our city," Boston Mayor Marty Walsh said.In Boston, many streets were closed and city officials advised people not to drive or walk in high water.Historic flooding prompts rescuesQuincy residents who were rescued from inundated homes told CNN they'd never seen anything like this weekend's flooding."It was pretty scary," said Alyssa Fitzgerald. "Once you saw the National Guard, that's when I was like, 'OK, we should have evacuated.'"Fitzgerald and her husband hunkered down overnight after their home lost power with their 3-year-old son and 1-year-old daughter, she said."Not like anything we've had before," Fitzgerald said. "Much worse than the snowstorm we had."Only a few storms even can compare with this level of flooding, including a 1978 blizzard, a storm in 1991 and January's bomb cyclone, Dougan, the Quincy police captain, said Saturday."We've been doing evacuations all through the night and today," he said.The-CNN-Wire? & ? 2018 Cable News Network, Inc., a Time Warner Company. All rights reserved.  6092

As the holidays approach, many people are wondering how to safely celebrate. The CDC has urged Americans not to travel for Thanksgiving, and offering guidance for those who still want to go somewhere. Health officials weighed in on whether you need to quarantine before you visit family for the holidays."My own family, we usually have 100 relatives every year at Thanksgiving. Now, clearly, that’s not going to be happening this year. It’s going to be on Zoom for the big family, but I think there are ways that you can celebrate with your smaller family and get together safely, but it's going to take some work and some planning," said Dr. Tanya Altmann, a pediatrician and spokesperson for the American Academy of Pediatrics.Dr. Altmann says there are a number of steps people can take to protect themselves from getting COVID-19 this holiday season. Ideally, everyone would quarantine for two weeks before and after a get-together. Some families may think about switching their kids to remote learning if they are not already doing it."I don’t think its drastic. If you want to get together with elderly grandparents for Thanksgiving, I think keeping your kids home from school for a week and then testing them on day five to seven, assuming everybody is asymptomatic, can make a lot of sense. Again, I would still try to keep them a little distanced from the grandparents," said Dr. Altmann.But what if you can't switch your kids to remote learning? Dr. Altmann says then it won't be a true quarantine, but most schools that are in-person right now are doing everything right."They're masking, they’re distancing, they’re sanitizing and disinfecting, they’re hand washing. So, what we’re seeing is most kids are not catching COVID-19 in the school classroom during the school day, they're catching it at after-school activities, they're catching it on the weekends when they're gathering with friends or their families or doing things that maybe they shouldn’t necessarily be doing," said Dr. Altmann.So, how long should you quarantine last? For medical professionals, a quarantine usually refers to a person who's potentially been exposed but is not showing symptoms. It's a waiting period to help determine infection."I think really the best guidance is to wait that 14-day quarantine period to have some degree of confidence that you’re not going to become infected," said Dr. Beth Thielen, an Assistant Professor of Pediatrics at the University of Minnesota Medical School and an infectious disease physician. Dr. Thielen says, to be extra careful, you could also test yourself seven days into your two-week quarantine."A testing in between without symptoms is somewhat helpful because we also know there are a certain percentage of people who will develop asymptomatic infections and, in particular, this is probably important for children," said Dr. Thielen.However, testing rules and access varies in each state, so it's best to reach out to your local health official or doctor to find out about availability and turnaround times for results."So, I think for some, where now I'm hearing people are waiting days after a test, and so if you're planning to get tested before a trip and it's going to take four to five days to turnaround the test, that could be the entirety of your trip," said Dr. Thielen.Health officials advise erring on the side of caution, especially if you're planning on visiting elderly family members."I think the most important thing is to be really aware of that it's not just your family. 'Oh, we don't want to catch COVID, we might get sick' but that you could spread it to others who are even more vulnerable," said Dr. Altmann.Experts say to take the highest precautions to create the least amount of risk. 3756

At this extremely difficult time we would like to express our gratitude to all of those who have reached out to our family following the tragic loss of Alanna, June and Ruby. They were all loved dearly by their family and friends, and they will be greatly missed. We are broken-hearted by their loss but sustained by our faith. We believe in a loving Heavenly Father who comforts his children in the midst of their most painful trials. We are steadfast and confident in knowing that our family will be reunited in the life to come. We thank the police, other first responders, friends, family and the media for their kind words about these wonderful girls and their mother. We trust you will allow us private time to mourn. 731

As the NBA plans to resume action at the end of the month, the bubble the league has implemented in Orlando, Florida, appears to be working.On Monday, the league said that its latest round of tests netted no new confirmed coronavirus cases.The league has implemented a “bubble” for its players, meaning players are being confined to a hotel complex as Florida is grappling with a spike in recent weeks of COVID-19 cases. The complex also contains practice gyms for the players to workout.At the end of June, before players entered the “bubble,” the league found 16 coronavirus cases out of over 300 tested.The NBA is moving forward with a planned relaunch on July 30, with 22 teams of the league’s 30 teams participating in the conclusion of the season and subsequent postseason based at Orlando’s Wide World of Sports. Fans will not be allowed to watch in person.The league suspended play on March 11 when Utah Jazz star Rudy Gobert tested positive for COVID-19 moments before tipoff in a game against the Oklahoma City Thunder. Several games were allowed to conclude that evening, but the NBA has not held a game since. 1129