ST. ALBANS CITY — Last weekend, Northwestern Medical Center staff knew they had a real problem on their hands.  An influx of COVID-19 patients — 10 in total — stressed staff resources close to the breaking point. Simply put, they needed more nurses ASAP to get through the weekend.

In just 24 hours, they were flown in.

Rare collaborators

Nursing shortages aren’t exactly a new problem for rural hospitals, Deanna Orfanidis, NMC’s chief nursing officer, told the Messenger. For decades, young professionals have flocked to larger metropolitans to access more diverse job markets and find higher-paying work. 

As a result, rural hospitals have had to set up nurse training pipelines to keep a few in the area. But over the weekend, NMC had a legitimate crisis when there were simply no more nurses to be found. 

With beds filled up, NMC CEO Dr. Dean French called on the Vermont Department of Health. The state then reached out to the University of Vermont Medical Center, which through its connections, found in record time the traveling nurses who were needed. Four were flown in from the west coast and midwest to fill in. 

“They’re here. They’re working. We’re just so grateful for the support,” Orfanidis said. “They’ve been well received by the clinical teams at Northwestern to support the just in-time need. They were able to come and move into taking care of patients.”

The four crisis travel nurses are expected to leave Saturday.

Long-term problems

Orfanidis said the medical field’s staffing problem has been a long time coming. While the COVID-19 pandemic has definitely stretched hospitals, she pointed to decades-long trends as the root issues behind staff shortages, and it’s not just rural hospitals being stretched.

As Daniel Hudson, UVMMC’s inpatient nursing director, explained, the medical field is currently experiencing a perfect storm of issues related to staffing. 

One major issue is that the general population is getting older, especially in Vermont. The average patient is typically less healthy as a result, and they require more care.

“The patients are sicker, and there are more patients hitting our emergency department,” Hudson said. “Our volumes of care — in the emergency department in particular — the sickness of those patients and the number of those patients that need admission to the hospital, it was high in 2019 before COVID.”

When the COVID-19 pandemic hit, those stressors were exaggerated, and health professionals are now being pushed out of the field because of fatigue. Some are exhausted after being stretched thin for the last 19 months. Others don’t want to deal with today’s COVID patients, who can be antagonistic towards medical staff. Overall, they’re experiencing what Orfanidis calls “compassion fatigue.”

“With this fourth surge, it’s different than the initial surge when the pandemic first occurred. Nurses were seen as heroes,” Orfanidis said. “And now what we see when we’re met and taking care of those in the emergency department and in outpatient services, the families aren’t as gracious.”

As nurses leave the field, medical providers have then turned to costlier traveling nurses to fill the gaps. With demand for traveling nurses increasing, pay ranges skyrocketed, jumping to $180 an hour in some cases with additional pay included for housing, food and traveling costs.

Rural hospital budgets are having a hard time keeping up, which creates circumstances like the one seen this past weekend at NMC.

“We’ve been all along aggressively recruiting,” Orfanidis said. “Having said that, the supply and demand, we’ve been on the wrong side of the equation. Having this respite, for nurses to come and step in has been tremendous for the community.”

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