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Missouri hospitals can't find enough nurses to handle the record number of COVID patients

Jared Wilson, RN, and Andrea Wiese, RN, care for patients in the COVID-19 unit within the Progressive Care Unit at University Hospital.
Justin Kelley
MU Health Care
Jared Wilson, RN, and Andrea Wiese, RN, care for patients in the COVID-19 unit within the Progressive Care Unit at University Hospital.

University of Missouri Health Care will require nurses who don’t usually care directly for patients to take four 12-hour hospital shifts during the next two weeks as it struggles under a record COVID-19 caseload.

Notice went out Jan. 14 for “licensed nurses and other licensed health care professionals at the School of Medicine currently working in research, administration, etc., who are being asked to participate in MU Health Care’s clinical labor pool,” MU Health Care spokesman Eric Maze wrote in an email to The Independent.

The demand for extra staff isn’t limited to central Missouri. Ten St. Louis-area hospitals are asking for federal staffing support through the State Emergency Management Agency, the St. Louis Post-Dispatch reported.

The initial notice from MU Health alerted nurses that they would be expected to work in the hospital. Licensed nurses who currently do not have assignments involving clinical care must work two 12-hour shifts each of the next two weeks, according to a Wednesday email provided to The Independent and written by Jeanette Linebaugh, senior director of operations in the school’s Department of Surgery.

Those whose duties currently involve clinical care are expected to take one 12-hour shift at the hospital by Feb. 4, she wrote.

“Weekend and nights are highest need,” Linebaugh wrote.

Along with hospitals across the state, University of Missouri Hospital in Columbia has seen its COVID-19 inpatient load grow rapidly this month, from 80 on Jan. 1 to 122 on Thursday afternoon. Of that number, 62% are unvaccinated.

The state Department of Health and Senior Services reported 3,704 hospital inpatients on Monday, with preliminary data showing that increased to 3,784 on Tuesday, the highest number of any point in the COVID-19 pandemic. Hospital caseloads statewide have increased 42% since the start of the year.

“The nationwide shortage of health care workers coupled with the ongoing and increasing patient census, increasing demand for COVID-19 testing and vaccinations, and growing shortages in our nursing workforce have strained our patient-facing nursing teams, and we need to provide them with additional support,” Maze wrote.

Salaried employees will be paid $75 an hour during their shifts, while those who work on an hourly rate will receive $25 an hour extra, plus any available bonuses, Linebaugh’s email wrote.

MU Health Care is also increasing its vaccination requirements, KMIZ-TV in Columbia reported Thursday afternoon. Employees who do not get a booster shot when eligible could face termination, the station reported.

Statewide, only about 20% of hospital beds, and 18% of ICU beds, are available, state health department data shows. The shortage is most keenly felt in the Kansas City area, where only 15% of beds are available, and the St. Louis region, where 18% of all beds and only 13% of ICU beds are available.

“Emergency rooms continue to stack up,” said Dr. Clay Dunagan, chief clinical officer for BJC HealthCare, during a briefing Wednesday by the St. Louis Metropolitan Pandemic Task Force. "We have a large number of people who have to stay in an emergency room overnight or even multiple days before they can be transferred to get the care they need.”

There is some evidence in the daily case reports that the omicron variant wave has peaked in St. Louis metropolitan area, but those reports also show cases are increasing rapidly in more rural areas of the state.

Over the past seven days the number of reported cases declined 28.6% in the Missouri portion of the St. Louis Metropolitan Statistical area but increased 61% in 22 southwest Missouri counties.

The decline is evident throughout the St. Louis metro area, but is most pronounced in St. Louis and St. Louis County, the only jurisdictions requiring masks in public places. On Wednesday, Circuit Judge Richard Stewart denied a request from Attorney General Eric Schmitt for a temporary restraining order to block the St. Louis County mask mandate.

Cases are down 34% in St. Louis County and 37% in St. Louis over the past week.

The state health department reported 16,509 additional coronavirus infections on Thursday, the second highest number of the pandemic. The seven-day average of reported cases, 12,152, is only 1.2% higher than a week ago, but it is more than four times the rate seen in late December.

There have been 229,610 coronavirus cases reported so far this month by the state health department. That is 131% more than the full month of December and 103,489 more than the previous highest single month, November 2020.

The daily increase in hospitalizations has slowed in St. Louis, said Dr. Alex Garza, chief community health officer for SSM Health. That doesn’t mean the omicron variant wave is over, he said.

“We have more people in the hospital now than at any other point in the pandemic,” he said, adding later that there will be “hundreds in the hospital for weeks to come.”

Keeping an accurate track of new infections has become more difficult with the widespread use of rapid-result home antigen tests. The Columbia-Boone County Public Health and Human Services Department on Thursday set up a system for county residents to report positive results from their home test.

Boone County has the highest infection rate in the state so far this month of 118 local health jurisdictions and the second-highest rate over the past seven days. The county health department has reported 7,255 cases since Jan. 1, equal to about 4% of the county’s population.

The department has received some reports from individuals about their positive home test but hasn’t tracked the data, spokeswoman Sara Humm wrote in an email. The new system is expected to increase reporting but not identify every positive result, she wrote.

“While we certainly encourage residents to report their at-home positive tests to us, we know that not everyone will,” Humm wrote. “So while we’ll capture a lot more at-home test results with this new system, we still won’t be able to capture every at-home test result.”

This story was originally published on the Missouri Independent.

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