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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 the debate over guns continues in Washington and in communities across the country, there's at least one place where owning a gun is technically required by law.In Kennesaw, Georgia, local law says that "every head of household residing in the city limits is required to maintain a firearm.""If you're going to commit a crime in Kennesaw and you're the criminal -- are you going to take a chance that that homeowner is a law-abiding citizen?" asked Kennesaw Mayor Derek Easterling.Wayne Arnold is one of those citizens. Among the weapons he keeps at home are an AR-15-style .223 caliber rifle, a variety of handguns and more."It gives me the ability to protect myself as opposed to being somewhere where you weren't allowed to have a firearm or it was frowned upon," said Arnold."More or less a political statement" 826

ATLANTA (AP) — Former President Jimmy Carter marks his 96th birthday Thursday, the latest milestone for the longest lived of the 44 men to hold the highest American office.Carter planned to celebrate at his home in Plains, Georgia, with his wife of 74 years, Rosalynn Carter, according to a spokeswoman for the Carter Center in Atlanta.The 39th president, in office from 1977-81, has largely receded from the public eye amid the coronavirus pandemic and his own health challenges due to a series of falls in 2019. He previously survived a dire cancer diagnosis in 2015.Yet Carter remains a quiet force still active in both politics at home and, through his post-presidential center, in public health and human rights advocacy around the world. 751

As the nation mourns the passing of Sen. John McCain, Arizona Republicans are holding a Senate primary Tuesday in which one of the candidates suggested the announcement that McCain was stopping medical treatment was timed to hurt her campaign.Kelli Ward, a former state senator who has courted the far-right during her campaign, suggested on Facebook Saturday that McCain's family released its statement saying the senator was ending medical treatment for brain cancer was timed to hurt her chances of winning Tuesday's primary.Ward staffer Jonathan Williams posted that he wondered whether McCain's statement was released "to take media attention off" Ward's campaign, which was beginning a statewide bus tour. "I'm not saying it was on purpose but it's quite interesting," Williams wrote."I think they wanted to have a particular narrative that they hope is negative to me," Ward responded, according to a screenshot posted by the The Arizona Republic.The news broke that McCain had died hours after Ward's comment. Ward's campaign did not respond to a request for comment on the Facebook post.On Monday, less than two days after McCain died of brain cancer, Ward tweeted, "Political correctness is like a cancer!"The attacks and insensitive remarks about McCain are just the latest in a heated primary race that has seen all three candidates align themselves with President Donald Trump, who attacked McCain relentlessly for three years, rather than McCain or retiring Sen. Jeff Flake, whose seat they are seeking to fill.Their decisions show how the path McCain cut through the Trump era -- breaking with the President on foreign policy, health care, immigration and more -- complicated his relationship with diehard Republicans in a state where the GOP electorate is now demanding fealty to Trump.Ward faces Rep. Martha McSally and former Maricopa County Sheriff Joe Arpaio in Tuesday's primary for Arizona's other Senate seat. McSally is seen as the strongest general election candidate to face likely Democratic nominee, Rep. Kyrsten Sinema.McCain fended off Ward's challenge in a 2014 primary. Since then, she's made a series of insensitive comments as McCain battled brain cancer.She called on McCain to step down last year, calling him old and near "the end of life" before his diagnosis and said afterward he should resign "as quickly as possible."Ward closed the race barnstorming the state on a bus tour with right-wing media personalities Mike Cernovich and Tomi Lahren, as well as Rep. Paul Gosar."Are we going to elect another senator cut from the same cloth as Jeff Flake and John McCain?" Ward asked the crowd at a campaign event Friday, eliciting shouts of "No!"After McCain's death, Ward tweeted: "We are saddened to hear of the passing of @SenJohnMcCain. His decades of service will not be forgotten by the men & women of Arizona. May God grant the McCain family comfort and peace during this difficult time."McSally, the Republican establishment's preference in the race, has mostly remained silent on McCain during the primary.But McSally's omission of McCain's name when touting her support for the National Defense Authorization Act, which was named in McCain's honor, when McSally joined Trump at a signing ceremony at Fort Drum in New York, angered McCain's daughter Meghan McCain.McSally's "inability to even mention my father's name when discussing the bill named in his honor is disgraceful (just as it was with Trump)," Meghan McCain tweeted. "I had such higher hopes for the next generation of leadership in my home state."Throughout the campaign, McSally has sought to avoid any distance between herself and Trump.On Thursday, McSally sought to dodge last-minute controversy that could undercut her primary campaign, repeatedly avoiding reporters' questions about whether she considers Trump honest and trustworthy. The questions came after Trump attorney Michael Cohen's guilty plea and claim that Trump knew about hush payments to alleged mistresses during the 2016 campaign. McSally refused to address Trump, saying only that Cohen was "all over the map, contradicting himself, lying in order to save his ass."After McCain's passing, McSally tweeted, "John McCain was one of Arizona's greatest Senators, one of our country's finest statesmen, and an American hero who risked his life to defend this great nation. He loved this state, and he loved this country."I pray that God comforts Cindy and the entire McCain family. My heart is with them, and Arizona grieves with them."Arpaio, who was pardoned by Trump last year after being convicted of criminal contempt related to his hardline immigration tactics, complained in a since-deleted tweet on Friday that Cindy McCain had blocked him on Twitter."I tweeted out my thoughts & prayers for" McCain, his campaign account tweeted, and Cindy "BLOCKS me on twitter?"Arpaio tagged Trump and several news outlets in the tweet.The-CNN-Wire 4934

At least 14 people were sent to the hospital Saturday after a storm knocked over concert entrance trusses at an Oklahoma outdoor concert venue hosting the Backstreet Boys and 98 Degrees, a spokeswoman for the property owner said.The staff at the venue had begun evacuating fans after lightning was spotted, Kym Koch Thompson, a spokeswoman for WinStar World Casino and Resort, said.But about 150 people in line "did not heed staff's warnings."Thompson said the area was pounded by heavy rain and winds as strong as 80 mph. 530

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