Exhausted D.C.-area hospital workers feel abandoned amid the omicron surge Despite record levels of hospitalizations, health care workers say the support – both financial and public – has fallen away.
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Exhausted D.C.-area hospital workers feel abandoned amid the omicron surge

During a protest in May 2020, nurses lined empty white shoes in front of the White House. A a year and a half later, many healthcare workers say they feel abandoned amid the omicron-driven surge in hospitalizations. Tyrone Turner/WAMU/DCist hide caption

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Tyrone Turner/WAMU/DCist

Most days, Esmeralda Salgado doesn't have time for her 30-minute lunch break. The Howard University Hospital nurse has worked long hours since she started there in 2003, but her 12-hour shifts have become more exhausting – and even dangerous, she says – in recent weeks.

The last time she worked on a floor designated for COVID-19 patients, Salgado found herself caring for six patients at a time — far beyond the number of people she can reasonably treat. Caring for five at a time is pushing it, and that's if all those patients are not too critically ill.

"We come to work every day, we only got two nurses on the floor most of the time, with 13 patients, 14 patients," she says. "That's not safe anymore."

Salgado and dozens of D.C. nurses staged a protest on Thursday, Jan. 13, calling attention to a staffing crisis that has left nurses at local hospitals feeling increasingly desperate.

"I love nursing. I love bedside care. But I'm beginning to resent it and regret it," Salgado says.

For Salgado and other healthcare workers across the region, the omicron-driven surge in hospitalizations — the highest recorded since the pandemic began — feels distinctly different from previous waves. While the variant appears to lead to less severe illness, the sheer volume of cases in the community has emergency rooms overrun. Staffing levels, meanwhile, have been decimated by both COVID-19 cases among hospital employees and a staggering amount of vacancies driven by burnout.

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Responding to their fourth COVID-19 wave, healthcare workers are bone tired. Yet unlike during previous case surges, workers who spoke with DCist/WAMU say the support – both financial and public – has fallen away.

Esmeralda Salgado, a medical-surgical nurse at Howard University Hospital, protested on Thursday, January 13. Amanda Michelle Gomez/WAMU/DCist hide caption

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Amanda Michelle Gomez/WAMU/DCist

By early January, the District, Maryland, and Virginia hospitals were seeing more people hospitalized with COVID-19 than ever before in the pandemic.

In recent weeks, Gov. Ralph Northam, Gov. Larry Hogan, and Mayor Muriel Bowser have all declared public health emergencies, after letting them lapse over the summer. These orders allow hospitals to implement "crisis standards of care" and beef up staff by hiring new graduates or expanding the scope of practice for certain providers. Meanwhile, federal health officials have tried to minimize staffing challenges related to COVID-19 by easing isolation guidelines.

Since mid-December 2021, Maryland hospitals have been directed to limit elective surgeries. Shortly before the new year, D.C. pledged $15 million to help hospitals address staffing shortfalls and pay travel nurses. According to D.C. Hospital Association spokesperson Jennifer Hirt, due to the limited staff, many hospitals are relying on travel nurses more now than in previous surges.

And across the region, officials and hospitals are pleading with residents to avoid visits to emergency rooms for COVID-19 tests or mild symptoms. Health officials also underscore that hospitalizations are driven by the unvaccinated, as people who haven't received the vaccine are 8 times more likely to end up in the hospital and 14 times more likely to die.

At Capital Region Medical Center in Prince George's County — the county seeing the highest number of cases in Maryland — the majority of ICU beds are filled with COVID-19 patients, according to Lauren Reichard, a nurse for the unit. Meanwhile, the hospital is responding to the influx with fewer nurses, particularly those with experience and institutional knowledge.

"We lost a lot of people who had been there for decades," the kind of colleagues that one could turn to for help with more complex medications or medical equipment, Reichard tells DCist/WAMU. "[Nurses] who have seen more, have done more, have been a part of the hospital for longer."

At Howard University Hospital, there are over 100 nurse vacancies, according to the DC Nurses Association.

"They come. They go," says Salgado. "Nobody stays."

Howard University hospital did not respond to a request for comment about the vacancies.

Sophia, who asked to be referred to by her first name to speak candidly about working conditions, says many of her nursing colleagues at Capital Region Medical Center have retired early or left the profession entirely. Others are departing for nursing roles with better pay.

"The hospital doesn't do much to retain the people that they have," like offering monetary incentives, says the veteran nurse of three decades.

Capital Region Medical Center did not respond to a request for comment on its practices to retain healthcare staff.

Some have opted to become travel nurses for just that reason. "You can work for 13 weeks and then you get a break in between, and make your own schedule and you get paid more," says Carine Uwaifo, a medical-surgical nurse at Capital Region Medical Center.

Reichard believes those kinds of benefits could help the current staffing crisis.

"If we are better able to compensate nurses with hazard pay and [paid time off] and just simple appreciation, that would just make all the difference," Reichard says.

Meanwhile, the job vacancies have been compounded by the rise in cases among healthcare staff themselves. During the week between Christmas Day and New Years Day, one in four D.C. hospital workers was out due to COVID-19, according to DC Health Senior Deputy Director Patrick Ashley.

D.C. nurses encourage drivers to honk in support of health care workers who are responding to yet another COVID-19 wave. Amanda Michelle Gomez/WAMU/DCist hide caption

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Amanda Michelle Gomez/WAMU/DCist

Health systems have attempted to implement support programs for exhausted staff. INOVA has partnered with the Caring for Caregivers program, a peer group that assists healthcare workers through processing trauma and burnout, for example, and VHHA is hosting an annual summit next month focused on health professional resiliency, according to Julian Walker, the vice president of communications for the Virginia Hospital and Healthcare association.

But despite the extraordinary stress, many at regional hospitals are not being compensated extra. Hirt, spokesperson for the D.C. Hospital Association, which represents the interests of 13 member hospitals, says she is not aware of any local hospitals offering hazard pay, instead focusing on "retention activities."

Some unions representing local health care workers are encouraging lawmakers and employers to fund hazard pay, offer one-time bonuses, or increase paid time off, as hospitals did early on in the pandemic.

"Healthcare employers have largely stopped offering additional pay, except as an incentive to take on more shifts," says Lisa Brown, the executive vice president of the Maryland and DC division of 1199SEIU. "At the same time, healthcare workers of all titles – nurses, aides, technicians, cooks, and environmental services workers – have been showing up day in and day out and have been dealing with overwhelming stress and grief."

Edward Smith, the executive director for DC Nurses Association, a professional organization for registered nurses, called extra compensation a "band-aid" solution, instead encouraging the hospitals to focus on hiring more workers and not give nurses more responsibilities or patients.

"No amount of money is going to keep you there, and no amount of money is going to change your ability to care for people," he tells DCist/WAMU. "We're asking for staffing ratios to be legislated." (This has long been an issue; The D.C. Council considered legislation to address staff ratios back in 2013.)

Until staffing pitfalls are addressed, they will continue to impact health care workers both on – and off –the clock. Kimi Chernoby, an emergency medicine doctor for six D.C. and Virginia hospitals, had to cut her holiday visit with family short in order to pick up weekend shifts at a strained emergency room.

"You need everyone for the emergency department to function," Chernoby says, who declined to say where she works in order to speak openly. "Nurses have a cap – they can only safely take care of so many patients at one time. So if you're down to three nurses and a nurse only manages five beds, your emergency department has to shut down 15 beds. [That can be] 50% of the capacity of a small community hospital."

Meanwhile, treating unvaccinated COVID patients has been a particular source of frustration. Chernoby has had patients resist the vaccine and harass her as an Asian woman for "causing the pandemic," all while she takes care of them. She feels like both the public and policymakers abandoned the healthcare workforce, either by resisting vaccines or refusing to reinstate mask mandates.

Chernoby is 17 weeks pregnant with her first child, and found out in early January that her obstetrician would no longer be allowing visitors during appointments due to the rise COVID-19 cases.

"This is supposed to be a really exciting time for us" says Chernoby, whose husband is also a healthcare worker.. "[Now], the community is really, it feels like, abandoning the healthcare system...and then the consequence is that I get punished. I can't have my support person with me."

Asked if she has ever had moments where she considers leaving the job, Chernoby says yes – if it weren't for the student loans she has to pay off.

"I think the sense that we are all left with is just that we are all kind of a commodity," she says. "We are very much just like pawns in the system."

Dominique Maria Bonessi contributed reporting.

This story is from DCist.com, the local news site of WAMU.

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