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Health care workforce stressed amid third COVID wave

Katie Tabeling

For almost two years, Delaware’s doctors and nurses have been on the front line of this pandemic. But now the omicron variant and high hospitalization rates combined with a workforce shortage are creating a perfect storm of challenges in hospitals.

Every day, the state records thousands of new cases per day. Nearly 750 people are hospitalized with COVID-19 complications, as of Jan. 11. Emergency rooms are so filled that patients waiting for an assessment can wait for hours before seeing someone. Some patients may be treated in other non-traditional areas like cafeterias while waiting for bed.

At the heart of it all is a nationwide workforce shortage, and nurses and doctors are no exemption. Nationwide, nearly half a million workers have left the health care industry since February 2020, according to the U.S. Bureau of Labor Statistics. 

“I don’t think we’re any different than any other organization right now that has been really worn down for the past two years,” Bayhealth Vice President of Medical Affairs and Quality John Fink said. “It’s been a burden to a lot of them, even though they feel it’s a calling to this job … but there are [also] going to be people who even over the next few weeks reach that breaking point.”

Dr. Muhammad H. Tahir treats a patient
at Bayhealth Hospital, Sussex Campus.

The Delaware Department of Labor reports that the health care and social assistance industry had 74,100 workers as of February 2020. That includes registered nurses, personal care aides, nursing assistants, medical secretaries, home health aides, physical therapists, surgeons and more. 

The lowest point for health care and social assistance workers — like most of Delaware’s workforce — came in April 2020 when the world was first coming to grips with COVID-19. That month, the state reported 65,800 workers in the health care and social sector, shedding 8,300 jobs.

In the months since, workers returned to the office. But the strain of being the foremost front-line workers in a global pandemic while handling a backlog of appointments and procedures postponed during other waves takes a toll. By November 2021, health care and social assistance workers had risen to only 71,300, or 2,800 workers less than the pre-pandemic period — though it’s unknown if they left the industry entirely, moved out of Delaware or now work at a facility out of the state.

Concurrently, Delaware’s hospitals were facing a slow but steady rise in COVID infections. By the end of December, the state’s largest health care system ChristanaCare announced it was operating at around 110 and 150% capacity, with 1,800 patients hospitalized for non-COVID and COVID-related illnesses and conditions.

“We know that burnout existed before the pandemic, and the pandemic has definitely increased stressors,” said Dr. Heather Farley, who directs a comprehensive staff-support program at ChristianaCare. “COVID-19 has profoundly changed the way many of us are practicing.  We’re communicating through masks. We’re caring for patients who are sometimes separated from their loved ones. There’s more suffering, and  our caregivers who care so deeply are being exposed repetitively and it certainly takes its toll.”

As the pandemic enters into its third year, health care workers are also seeing some of the public sentiment shift to frustration and sometimes anger. Bayhealth Assistant Medical Director Ellie Salinski, who oversees the Kent emergency department, said that she has seen a colleague get assaulted by a patient and clerks get cursed out on phone calls.

“People are angry, they’re waiting. I just want everyone to understand that we are all dedicated to helping patients to serve our community and we’re all doing the absolute best that we can,” Salinski said during the governor’s press conference on Dec. 29. “We’ve pushed past the limits we didn’t realize what we could surpass.”

Her experience is not common, but they do happen, according to Bayhealth officials. The next month will be a test to the health care systems, particularly as the highly contagious — but perhaps less fatal — omicron variant may bring a crush of more patients to emergency rooms on top of flu season and hundreds of other patients for non-COVID issues.

Delaware’s health care sector has lost 2,800 workers throughout the pandemic, leading to higher stress on the remaining
workers as patient totals skyrocket amid the omicron variant surge. | PHOTO COURTESY OF BAYHEALTH

“The next few weeks will be challenging, but the bigger concern is not this variant but the months and even years ahead of what this does to health care as a profession,” Fink told DBT. “Those who are leaving are going to be the difficult ones to replace, because it will take new people coming into training programs which could take years in the making.”

Gov. John Carney and his administration have taken steps since the pandemic started to maintain Delaware’s health care workforce. In the first two years, Carney launched a rapid workforce training program, Forward Delaware, that helped aspiring nurses receive accreditation quickly and for free, and he has also relaxed licensing requirements to allow nurses who have lapsed licenses or those from different states to easily start work again.

At the end of 2021, Carney also allocated $78 million in federal stimulus money to health care facilities struggling with staffing shortages. Hospitals like ChristianaCare offered nurses $10,000 sign-on bonuses while Bayhealth recently announced a Bahamas vacation raffle combined with full-time benefits for nurses and technical position workers willing to cover part-time weekend shifts.

As the state settles into winter, Carney has mobilized 100 members of the Delaware National Guard to be trained as certified nursing assistants — with the idea that these guardsmen will handle non-critical duties like meal prep, paperwork, and more, while the state’s health care professionals can focus on the patients.

“The health care workforce is certainly under stress right now. Hospital care will continue for patients, although it may be in creative settings like a cot in a hallway. But that being said, with record COVID numbers and flu season, this may be the greatest challenge in health care ever seen,” said Wayne Smith, president and CEO of the Delaware Healthcare Association. “There are going to be serious conversations on being creative to access this workforce in the days ahead.”

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