Southern Oregon Hospital Staff Weather ‘Siege Conditions’ Of Burnout And Stress
For much of the COVID-19 pandemic, our ability to manage the virus was measured by hospital bed space, respirators and personal protective equipment. Now it’s clear that medical staff are the limiting factor. And in Southern Oregon, hospitals and staff are being stretched thin.
For months hospitals in Southern Oregon were spared the first waves of COVID-19 infections. But in the last few weeks they’ve been seeing a surge in hospitalized patients.
“It has never been like this,” says David Baca, a registered nurse in the ER department at Asante Rogue Regional Medical Center in Medford. “We are transferring patients to our Ashland Community Hospital. They are busy as well. They’re very full. Our sixth floor here on med-surg is full of COVID patients.”
Baca says he and many of his coworkers are working up to 70 hours a week. Some have contracted the virus themselves and had to leave work to recover.
Hospital staffing shortages are a concern nationwide. Pandemic or not, rural areas such as the Rogue Valley have fewer resources.
“We’re the biggest hospital in the valley, so when we have no staff or short staff, it’s hard to pull from other places who need the staff or don’t have any staff as well,” Baca says. “We have nowhere to pull from. Portland [Providence], they can pull from [Providence] St. Vincent. They have another gigantic hospital to go to that’s in the health system. With us it’s just harder. If we’re short, we’re short.”
Conditions are similar at Providence Medford Medical Center where Kate Kitchell is the interim chief nursing officer.
“We are managing day to day,” Kitchell says. “The staffing and the number of beds – staffed beds – are extremely tight. And we are constantly reviewing our availability to take on more patients.”
Kitchell says they’re able to handle the current volume of patients but the biggest constraint at the Medford hospital is the number of available caregivers.
“People are burnt out,” she says. “They’re tired.”
“Medical staff are working under siege conditions with total uncertainty on top of that,” says Diane Solomon, a psychiatric nurse practitioner in Portland.
Solomon provides mental health care to medical workers in Oregon. She says working overtime without much time off, nearly a year into the pandemic can lead to burnout at a time when staff are most needed.
“Health care organizations, the employers, are not doing a good job of taking care of their employees,” she says. “In fact, a lot of the nurses feel like they’ve been completely disrespected. On one hand they’re told they’re heroes, but then on the other hand they’re told to work under conditions that everyone knows are suboptimal.”
The strain on medical staff can be even more emotional than physical. They work in dangerous conditions, treat people who downplay the disease, and soon doctors could be faced with having to ration care.
“I’ve had an ICU nurse in tears after conversations with family members who believe that we were trying to kill their family member,” says Dr. Somnath Ghosh, a critical care doctor and the ICU medical director at Asante Rogue Regional Medical Center. “I mean this is the same nurse who spends 12 hours every day in a hot zone, encased in uncomfortable PPE, doing all she can to keep the patient alive.”
If the local infection rate does not change, Ghosh says, there’s a good chance doctors will be put in a position of having to decide who gets critical life support and who doesn’t.
“No health care provider should have to choose which patient lives or dies,” he says. “No caregiver should have to bear that burden of making that decision. And yet, here we are.”
Diane Solomon says the cost of physicians or nurses leaving the health care profession is huge. And right now, medical staff are in a complicated position – needing to show up at work, while also protecting their own personal boundaries to stay healthy.
“Hopefully this will teach them that they have to care for themselves first,” Solomon says. “They have to stand up for their own needs or they’re not going to be useful to anyone and they will get burnt out and they will not be able to work.”
Dr. Ghosh at Asante says he knows at least five ICU nurses who have tested positive for COVID-19. Eighteen caregivers have tested positive for the virus in the Providence hospital network, which includes their Medford campus as well as seven other hospitals.
As infection numbers continue to climb in Oregon, public health officials say the hardest days of the pandemic are still ahead.