Pandemic burnout worsens nursing shortages in hospitals

AMNA NAWAZ: More than three years since the start of the pandemic, there are still long waiting times at both hospitals and for in-home care.

Stephanie Sy explores how the medical staffing shortage is affecting patients and why nurses are leaving hospitals for other jobs.

STEPHANIE SY: Brendan, a first grader at an elementary school outside Phoenix, Arizona, has been through a lot in his young life.

Even attending school was a victory.

His clap suggests he's having a good day.

LAURIE SANG, Mother and Caregiver: Brendan is 6, almost seven.

He was born with half a heart.

And he's got a lot of other medical complexities as well.

STEPHANIE SY: His mom, Laurie Sang, says Brendan has had 21 surgeries and has been in and out of the hospital since he was born.

But since the COVID pandemic, his care has suffered.

Laurie recalls a recent visit to a local children's hospital.

LAURIE SANG: That was a respiratory issue.

The last time I took him, we were in the E.R.

For 21 hours before they could find a room for him, because they just had no -- they didn't have enough beds and enough nurses.

STEPHANIE SY: When you finally did get care, did you feel, like, rushed?

LAURIE SANG: You could tell that they were stressed themselves, which -- and I don't blame them, because, I mean, he was put in an ICU setting.

They had more patients than they should have had, each nurse.

The national nursing shortage dates back decades, but the COVID-19 pandemic pushed it to crisis levels.

One study predicts that, in the next two years, there will be a shortage of up to 450,000 bedside nurses in the U.S.

In countries around the world, medical workers are pleading for more support.

PROTESTER: What do we want?

PROTESTERS: Safe staffing!

PROTESTER: When do we want it?

PROTESTERS: Now!

STEPHANIE SY: Earlier this year, thousands of nurses in New York went on strike to protest their caseloads.

In the U.K., nurses and ambulance staff staged the largest protest in the National Health Service's history last month.

And, recently, in Spain, hundreds of thousands of public health workers protested budget cuts.

No organized protests, but an emergency department packed with patients at Valleywise Health, a public hospital in Arizona's largest county.

Like many hospitals, they're having a hard time keeping and attracting nurses and other medical staff.

SHERRY STOTLER, Chief Nursing Officer, Valleywise Health: We have strived really hard to keep the beds open.

STEPHANIE SY: Chief nursing officer Sherry Stotler has been at Valleywise for over 18 years.

Exactly how severe is the shortage?

SHERRY STOTLER: We're probably around 440 positions that we could fill.

STEPHANIE SY: Four hundred and forty positions are unfilled?

SHERRY STOTLER: Right now, we're utilizing contract labor to cover a lot of those positions.

They might stay a few rotations, and then they move to the next state or job.

So I think that, for us, it puts a lot of pressure on us to have stability foundation for the care we're providing.

STEPHANIE SY: Valleywise is so short-staffed, it has closed several behavioral health units.

Patients are on a waiting list for care.

Last year, Arizona ranked among the top five states with the most critical hospital staffing shortages.

Many workers are leaving their permanent hospital jobs in search of less stressful work.

The pandemic was brutal on front-line medical workers.

TIAN LEEK, Nurse: The patients were just very, very sick and just a lot of physical, mental and emotional stress in the hospital for the patients and for the staff that's been caring for them.

STEPHANIE SY: Many quit, but Tian Leek, a single mother, stayed.

TIAN LEEK: You're not getting quite as much break and not having as much time to spend with the patients, and just really being rushed to get things done and meet all the same obligations that you need to meet just to get the job done.

STEPHANIE SY: Leek was one of more than a dozen nurses who attended a recruiting event for a private nursing service.

JASMINE BHATTI, Co-Founder, Navi Nurses: So, we can help fill that gap to make sure people get the care they need.

STEPHANIE SY: Jasmine Bhatti is the co-founder of Navi Nurses, which provides home nursing care on demand.

JASMINE BHATTI: Hoping that, with our new model of care, we can not only help retain the nursing work force, but also provide people better health outcomes.

STEPHANIE SY: Bhatti herself was a practicing nurse until about a year-and-a-half ago.

JASMINE BHATTI: I was just tired, exhausted and definitely burnt out.

My heart hurt from everything I'd seen and worked through.

STEPHANIE SY: Bhatti says she saw firsthand how high nurse-to-patient ratios could affect patients.

JASMINE BHATTI: There was one night at work that I questioned whether or not nursing was for me.

And it was because, by 11:00 p.m., I hadn't been in to see three of my five patients.

It just makes you feel defeated.

Two of my patients, I had to send off to the ICU.

One almost died.

It just makes you feel defeated.

STEPHANIE SY: And that's because there should have been enough nurses for you to only have to do two or three, is what you're saying, not five?

JASMINE BHATTI: Right, not at that level of care that these people required.

It's not safe.

It wasn't safe that night.

STEPHANIE SY: And the shortage also extends to home health care.

Paula Skladany-Law suffers from multiple sclerosis and has needed a home nurse for several months to dress a wound on her lower back she can't reach.

But finding reliable home nurses was difficult.

PAULA SKLADANY-LAW, Patient, Navi Nurses: People should be able to get the treatment and the care that they need.

STEPHANIE SY: The Navi Nurse that comes four times a week is a bright spot in her day.

NURSE: Oh, perfect, 112 over 73.

STEPHANIE SY: Attentive, thorough and experienced.

But the service is not currently covered by insurance.

PAULA SKLADANY-LAW: I have to pay for concierge nursing, which I didn't know was a thing before this happened to me.

I went through my savings.

STEPHANIE SY: While Paula burns through her savings, Laurie Sang is burning through vacation time caring for son Brendan.

The shortage of home health care nurses means that she's having to pull double duty.

LAURIE SANG: It got to the point where I have taken so many days off, and just because we had no help.

I was really worried about losing my job.

STEPHANIE SY: She still depends on therapists and other providers.

It takes a caring team to give Brendan what he needs to be.

But the team has shrunk.

Brendan recently got pneumonia, and an anxious Laurie decided not to go to the hospital.

LAURIE SANG: We made the decision as a family, you know what, let's try to battle this here.

STEPHANIE SY: Caring for him at home seemed safer than going to an understaffed emergency department.

Has it overall affected his health, the gaps in nursing care that you had hoped he would get?

LAURIE SANG: I think, had we had consistent nursing in home and in hospital settings, maybe, like, those illnesses where they have come on and we have had to take him to the hospital, maybe that nurse would have, like, been able to catch it, like, ahead of time and be like, you know what, let's get him to the doctor now.

Let's get him on antibiotics.

And we might have prevented those E.R.

Visits.

STEPHANIE SY: And Brendan's next medical emergency is never far from Laurie's mind.

For the "PBS NewsHour," I'm Stephanie Sy in Maricopa County, Arizona.