By Sarah Whites-Koditschek
Meliah Scarborough Mendoza was a medical social worker who helped discharge COVID-19 patients from a hospital in Mobile for the first year-and-a-half of the pandemic. When the hospital ran out of beds, she had to send COVID patients home before they were ready.
“We were all just kind of backed into a corner with impossible scenarios,” she said. “There’s just no good outcome, and you just kind of have to do the next-best right thing that you can.”
“It was kind of like working in a pressure cooker because administration, our bosses, everybody is saying, ‘get them out, get them out,’” she said of her role in discharging patients to free up space for more patients.
“So they’re saying, ‘get them out.’ But where do you put them?”
Mendoza is one of many health care workers who have left the frontlines of the pandemic due to burnout, compassion fatigue, frustration about low vaccination rates and seeing too much death.
As omicron surges in Alabama, even spreading amongst vaccinated health care workers, the state’s hospitals, which are already short-staffed, are now experiencing a critical shortage, particularly of nurses.
Dr. David Thrasher, a pulmonologist in Montgomery, said on Wednesday about 40% of health care staff in his clinic are unable to work due to omicron. There is a similar number of workers out sick at doctors’ offices and hospitals in the area.
“Several of the floors at the local hospitals here in Montgomery have been closed because we don’t have the staff to man them,” he said.
“A lot of our seasoned nurses are burnt out, post traumatic syndrome, depressed, quitting, you name it,” he said.
Nurses in Alabama make 8% less than in neighboring states, according to Dr. Lindsey Harris, the president of the Alabama Nurses Association. That incentivizes nurses in Alabama to leave the state for better opportunities and more money.
“It’s going to be imperative that we take care of our nurses here in the state,” she said. “Without health care, without a healthy Alabama, we have no economy.”
Nationally, a record number of Americans quit their jobs in 2021, a shift coined the “great resignation.” Departures were particularly high in the service, hospitality and arts fields. The health care field has lost half a million workers since 2020, according to the U.S. Bureau of Labor Statistics.
And one in five health care workers in the U.S. has quit their job during the pandemic, according to the research group Morning Consult.
Efforts at the national level to legislate pay increases for health care workers have failed during the pandemic. In Alabama, Governor Kay Ivey set aside $12.3 million federal COVID relief dollars to attract travel nurses last fall.
Harris, with the state nurses association, said she would like Alabama to set aside federal relief funds to retain staff nurses and reward their loyalty. Alabama is set to receive another $1.5 billion COVID relief funds in 2022.
“Staff nurses have received zero,” she said of the COVID relief funds. “(It’s) an opportunity to retain and maintain those nurses that have been faithful.”
“Nurses and respiratory therapists are woefully underpaid in my opinion, always have been,” said Thrasher.
The nursing shortage is exacerbated as the state reaches its highest-ever pandemic case rates with an average of 10,000 cases per day and hospitalizations with COVID once again crossing 2,000.
As of Wednesday, UAB had over 358 health care workers out sick with COVID-19 out of about 17,000 health care employees.
“Coupled with those who are out for testing, or because they have COVID positive family members to care for, that increases the strain on hospital operations,” said UAB spokesperson Bob Shepard on Wednesday.
Athens-Limestone Hospital, a small hospital in north Alabama, was down 58 employees Thursday, mostly vaccinated health care workers who still got COVID-19. Nine more were awaiting tests. Hospital administrator Traci Collins said the hospital is short on all positions.
“We have lost some staff to travel into larger hospitals that are offering more money,” she said.
She said nurses who would normally handle five patients are now caring for eight and she’s having to move staff around to run infusion centers while treating COVID-19 patients.
“I’ve stressed to my staff (and) to my managers, all we can do is all we can do and to try to keep morale up.”
For many health care workers, the allure of health care positions outside of COVID units, with less stress and higher pay, is a draw. For some entry-level roles, the hospital must compete with local businesses, like big box stores and fast food restaurants, which are increasing pay to combat worker shortages.
“I think a lot of people in entry level positions, they realized real quick if health care is for them or not,” Collins said about the stress of treating COVID-19, “because the things that we see, the things that we deal with, the exposure that you do have.”
Mendoza, the medical social worker, said overcrowded hospitals lead to worse outcomes and guilt for the health care workers who must navigate them.
“When you have a high nurse-to-patient ratio, mistakes start happening, the patients don’t receive the best care, and then the nurses are just spread too thin,” she
The hospital where Mendoza worked paid travel nurses much more than loyal, longtime employees. In some cases, travel nurses can make double or triple the amount of regular nurse pay to treat COVID-19. That disparity was one reason she saw many of her nurse colleagues leave.
Her new job as a medical social worker for a hospice agency pays and feels like a much better situation, she said.
“I’m able to show up more for my family and friends,” she said. “I feel like I’m a better clinician now. In general, I feel like I have more to give, because the life isn’t being sucked out of me.”