Nearly every day, employees at Southwestern Vermont Medical Center in Bennington have an incident command meeting where they talk about how they’re going to safely staff the hospital the following day.
That’s because so many workers are out with COVID, on top of high numbers of open positions. It’s been that way for months.
“Now it’s, if anything, slightly worse,” said Dr. Trey Dobson, the hospital's chief medical officer. “It shows that transmission in the community is every bit as high as it was in [the] omicron surge of late January.”
Other Vermont hospitals are feeling the same strain.
“We are constantly having people in and out, in and out,” said Dr. Joshua White, an emergency physician and chief medical officer at Gifford Medical Center in Randolph. “It's something of a logistical nightmare.”
“We're back to being at about 2% of our staff out with COVID,” said Meg Oakes, who leads quality and safety at Rutland Regional Medical Center.
What's going on with staff in hospitals is the same as what’s happening in restaurants and schools and stores across the state. But while many businesses can close for a few days or reduce their hours, hospitals do not have that option.
"Everything has slowed down. Yet one thing hasn't — and that's the number of patients coming into the door.”Dr. Trey Dobson, Southwestern Vermont Medical Center
To compensate, hospitals are asking staff to work extra shifts.
Many are also bringing in temporary nurses, doctors, and technicians. But those positions are expensive, and not always as efficient. It’s a financial burden administrators widely agree hospitals cannot sustain.
And the whole health care system is short-staffed. Someone might be ready to be discharged from the hospital, but there isn’t enough staff at the long-term care facility to take them.
Or the facility requires a negative PCR test.
“So we test them and they test positive,” said Oakes, from Rutland Regional Medical Center. “They don't have active COVID. They had COVID sometime in the last 90 days, whether they knew it or not. So those patients then have to stay with us.”
“As a result, everything is slowed down,” Dobson said. “Yet one thing hasn't — and that's the number of patients coming into the door.”
More from VPR: Vermont Principals' Association leader on current COVID surge: 'People are exhausted'
The patients that are coming in are generally sicker and in need of more care than in years past.
“The chickens have come home to roost in all of the health care that was neglected in the last couple of years,” said White, from Gifford Medical Center.
That’s for all sorts of reasons: Theystopped going to their doctor during the early months of pandemic. Their depression or anxiety got worse. The health care clinic near them closed. People who moved here were never able to get an appointment.
“We’ve got a lot of patients that did things like started drinking hard during the pandemic, and now those problems are cropping up,” White said.
For a lot of health care workers, it seems like they have fewer resources to deal with harder problems. And just as they’re able to solve one, like a personal protective equipment shortage, another pops up.
“It's like driving down the road in a car and they keep taking pieces off the car ... Eventually you're going to start taking pieces out of the system, and it's going to crash.”Dr. Joshua White, Gifford Medical Center
In the latest twist, hospitals across the country have had to ration a dye used in medical imaging called IV contrast. It’s how clinicians often figure out what’s wrong with a patient.
“It's like driving down the road in a car and they keep taking pieces off the car,” White said. “We're gonna take your rearview mirrors away. ‘Well, that's not as safe but I can probably figure this out without getting in an accident.’ We're gonna take the hood off your car. ‘Well, I guess the weather's nice, I can get through.’ But eventually you're going to start taking pieces out of the system, and it's going to crash.”
Working in this constant state of crises takes a toll. In a survey of nearly 12,000 nurses earlier this year, 52% said they intended to leave their jobs or were considering leaving.
That strain isn’t always obvious when you see clinicians at the hospital.
“They look fine, and they're doing their job, and they're doing their job well,” White said. “But a lot of them are at or near their breaking point. And you cannot tell externally, and we don't want patients to be able to tell, but the problem comes when they walk into HR and quit.”
This happened in the past year at his small hospital. A doctor in the middle of their career came into his office and said they were leaving their position. They didn’t want to work with patients anymore, he said.
“I don’t even – I don’t have a response to that,” White said.
Lexi Krupp is a corps member for Report for America, a nonprofit national service program that places journalists in local newsrooms to report on under-covered issues and regions.
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