By Liora Engel-Smith, Erin Petenko and Ethan Weinstein/VTDigger
RUTLAND — Asked what it’s like to do her job right now amid a staffing crisis and surging Covid-19 hospitalizations, a nurse heading home from Rutland Regional Medical Center on Monday, Jan. 17, was moved to tears.
Staff care for a new arrival to the University of Vermont Medical Center Intensive Care Unit on Dec. 2.
“It’s a lot. It’s just a lot. It’s really difficult right now,” said the woman, who declined to give her name. Having just finished her shift, she was already late to pick up her daughter, she said.
Vermont has hit new record-setting highs for Covid-19 hospitalization numbers last week, part of a trend of a rising Omicron surge. This week, the Vermont Department of Health reported 101 people were in the state’s hospitals with Covid-19 Tuesday, Jan. 25. There were 111 people hospitalized with Covid on Saturday and 104 on Sunday and 105 on Monday. Tuesday marked the 12th consecutive day with more than 100 Covid patients in Vermont hospitals.
Hospital staff and administrators have said they are under “extreme strain” due to the surge in Covid patients, people seeking care for other conditions and staffing shortage—an increasing number of health care workers are getting sidelined after being exposed or infected themselves, contributing to an ever-worsening shortage.
Late last week, the University of Vermont Medical Center — the state’s largest hospital — instituted emergency staffing procedures after some 400 workers were out, representing a roughly 5% reduction in the hospital’s 8,500-person roster.
Vermont’s small rural hospitals are feeling the same pressure, said Jeff Tieman, president and CEO of the Vermont Association of Hospitals and Health Systems.
“They’ve closed operating rooms and suspended surgery schedules,” Tieman said. “They’ve used CDC [Centers for Disease Control and Prevention] guidance in a couple of cases to bring back workers who are Covid-positive.”
At Gifford Medical Center in rural Randolph, CEO Dan Bennett said he could have 25 beds at the ready if he had a full staff, but these days he can eke out enough coverage for only 20 beds.
Overnight shifts are the most difficult to fill, Bennett said, which means that patients admitted in the wee hours sometimes stay in the emergency room until a shift change the following morning.
The pressure on UVM Medical Center compounds the challenge for Gifford and hospitals like it, especially when it comes to transferring critically ill patients, Bennett said. Before the pandemic, hospital staff could make a simple phone call to transfer a patient to a larger hospital — typically Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, or UVM Medical Center in Burlington. But now, these hospitals are often full, and patients are being sent to medical centers in Boston, Philadelphia and Rhode Island.
As with many hospitals, staffing has been a constant struggle in recent years at Copley Hospital in Morrisville, but absences caused by the Omicron variant have deepened the crisis, according to Chief Medical Officer Donald Dupuis. The 25-bed hospital usually needs four or five nurses per shift, he said.
“When you think about a hospital, everyone thinks about nurses and doctors, right off,” Dupuis said. “You don’t have to think about it very long before you’re thinking about the people who do the radiology, the people who make the lab run and even the people that make the food — I mean, you can’t have a hospital without all those people. And all of those areas just sort of get nibbled away.”
Some of the state’s medium-sized hospitals have adopted policies similar to those at UVM. To keep the emergency department and inpatient services running without interruptions, executives at the 61-bed Brattleboro Memorial Hospital cut elective surgeries and outpatient services by roughly a half, spokesperson Gina Pattison said Monday, Jan. 17.
Officials at UVM Medical Center expect to continue for at least a week at emergency staffing status. It’s an extraordinary step that puts significant pressure on a workforce that’s already stretched to capacity.
The policy means nurses can be reassigned to units with the greatest needs, and nurse managers — some of whom have not been on the floor for years — may have to care for patients, among other measures. If staffing levels remain inadequate, hospitals may have to turn patients away and refuse transfers.
As of Monday, more than 300 UVM Medical Center workers were unable to work, spokesperson Annie Mackin said.
Fraser Danielovich, a nurse at the Burlington hospital’s surgical intensive care unit, said the additional stress that has no end date has been difficult to handle.
“There’s just not a light on the horizon,” Danielovich said. “It’s not one of those magical things where it’s like, ‘oh, it’ll be over soon.’ For it to be over, there needs to be more nurses. You can’t just clap your hands and they appear.”
State officials have noted that reports of hospitalizations and deaths tend to lag behind reported infections. The Vermont Department of Financial Regulation, which keeps the state’s statistics, has forecasted that, even as cases “slow and possibly decline,” deaths may remain elevated through February.
The health department reported seven additional Covid deaths during the weekend, for a total of 41 so far in January. Overall, 521 people have died from Covid in Vermont since the beginning of the pandemic in March 2020.