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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

Atlanta police released images late Sunday of a second person of interest in the fatal shooting of an 8-year-old girl on the Fourth of July. Authorities are also offering a ,000 reward for information in the death of Secoriea Turner. At least two shooters were believed to be responsible for her death. Police had released a short video of the first person of interest last week. Photos were released Sunday night of the second person of interest.According to Crime Stoppers in Atlanta, the preliminary investigation suggests the young girl was riding in a car with her mother and an adult friend when they were confronted by a group of people blocking the entrance to a parking lot. At some point, someone in the group opened fire on the car, hitting it several times and striking the child. The driver headed to a nearby hospital, and Turner died from her injuries. Both persons of interest are seen in the images carrying rifles. The fatal shooting happened near the Wendy's where Rayshard Brooks was shot and killed by a police officer. 1051

BAKERSFIELD, Calif. — U.S. Customs and Border Protection officers executed the second largest methamphetamine bust recently along the southwest borders in CBP's history, according to the U.S. Drug Enforcement Administration.A press release states that a driver of a tractor-trailer with a "shipment that was manifested as medical supplies," pulled up to the Otay Mesa cargo border in San Diego Friday morning. An agent there at the time decided to pull the truck over for a more thorough inspection. Imagining systems, similar to an x-ray, were used to investigate the trailer and revealed suspicious components in the back of the trailer.Officers offloaded more than 1,800 packages mixed with medical supplies. That's when they discovered more than 3,100 pounds of methamphetamine, 64 pounds of heroin, 29 pounds of fentanyl powder, and almost 37 pounds of fentanyl pills. The narcotics are estimated to have a street value of .2 million, according to the press release.“This massive seizure is a testament of what law enforcement agencies can do when we combine forces – prevent over million worth of deadly drugs from entering our country; thus saving countless lives from addiction and overdose deaths,” said DEA Special Agent in Charge John W. Callery. 1271

As the opioid crisis continues to damage communities across the country, new mapping technology is helping family members of victims cope by allowing them to crowdsource an interactive memorial.The "Celebrating Lost Loved Ones" map, created a couple of months ago, now marks the lives of thousands people lost to opioids. The map was created by engineer Jeremiah Lindemann and allows users to add photos and short stories of loved ones who have passed away, including the place of their passing.The goal of the map is to create a place to honor and respect overdose victims across the United States."(We want a map) that emphasizes the human toll behind the opioid crisis with a visual record of the victims it is leaving behind," Lindemann said. 764

As new wildfires force tens of thousands of people out of their homes, reports are emerging of flaws in emergency alert systems throughout the west."Where I think the false sense of security was, if something really bad is going to happen, we'll get alerted well beforehand," said Vacaville resident, Will Carlson.Carlson and several of his neighbors say they received no warnings as the Hennessey Fire inched closer to their homes. At around midnight, Carlson saw the flames moving quickly down a hill in the distance. Carlson was one of the last to leave, working frantically to help save animals on the property."What I remember is this sinking feeling in my stomach, and this helplessness that this barn is going to go up in flames, and the horses will be burned alive," said Carlson.After making it out safely, Carlson was left wondering how this could have happened. "Every neighbor that we talked to it was the same story, we knew there was a fire in the area, we thought that we would get alerted, and nothing was said to us," said Carlson. Le'Ron Cummings, public information officer for the Solano County Sheriff's Office, says alerts went out to these areas. However, they cannot guarantee the targeted population will get the message if cell service, internet, or landline signals are impacted. He says it was determined that cellular services and power were affected by the fire.Solano County uses the Everbridge platform to alert residents via the AlertSolano program, delivering Amber Alert-style messages. Cummings says during an evacuation, the Solano County Sheriff's Office and allied law agencies do door-to-door notifications in addition to AlertSolano messaging. The Sheriff's office also uses the High-Low Siren system familiar in Europe to advise residents to evacuate immediately.Carlson says he is frustrated with the response because he believes he had full cellular service throughout the night, texting and posting to social media as he evacuated. "So I think that's where the frustration came in from that night. How many animals could have been saved? Could there have been less loss of life? And could structures have been defended better if we had more warning?" said Carlson. Carlson says two people in his neighborhood died in the fire; however, county officials say they have no reason to believe the alert system was associated with fire-related deaths.Napa County also experienced some kinks with its alert system, when a coding error prevented an alert from going out. Emergency officials say it was an error on the part of its vendor and that the message was not urgent. Staff realized the problem, and they were able to use a different platform to send out the alert. "It happens over and over again," said Art Botterell, who is now retired from the State of California's Office of Emergency Services.Botterell led the effort to develop the Common Alerting Protocol, which he says led to the creation of the FEMA Integrated Public Warning System and some products from the National Weather Service."We've got a pretty good penetration of cellphones, sirens, and telephone dialer systems, that's not usually what breaks down. What usually breaks down is that alert is not sent in time or not sent at all," said Botterell. He says during a 2017 wildfire in Sonoma County, that would prove deadly and destructive, officials failed to send an alert, fearing it would cause panic and clog roadways. Botterell says another reason alerts are often not sent is because officials believe they don't have enough information."It is fair to say that in a lot of cases, we have not given our public safety people the tools to issue public safety warnings effectively," said Botterell. Botterell says more training is needed and believes state and federal governments should provide more guidance to ensure effective responses.With the vulnerabilities in cellular towers and alert systems as a whole, Botterell says counties must utilize several tools to try and reach everyone."We've got a lot of technology. Now we need to get good at using it." 4083