By Sarah Whites-Koditschek
J.W. Cowan began his career 40 years ago trying to recruit nurses to what he now calls “forgotten man’s territory” in rural Alabama.
“A good rural nurse, I don’t know of anything that’s any tougher than that,” he said. “They persevere. They put the community, they put the hospital first, and my hat just goes out to them.”
Today, he is still trying to recruit nurses to Choctaw County near Mississippi, except he’s doing it in a pandemic. And the job has only gotten tougher and nurses are more in demand across the country, making it even harder to staff rural hospitals.
Cowan is an administrator at Choctaw General Hospital. His staff are working back-to-back, 12-hour shifts during the pandemic. One nurse worked a 96-hour week, and it’s not unusual for nurses to work seven days in a row to keep the hospital staffed.
Like at Choctaw General, hospitals across Alabama are reporting a shortage of nurses. Cases of COVID-19 are spiking ahead of a holiday season that experts fear could increase the rate of spread.
COVID-19 is time consuming for staff because patients require extensive care. Yet an increasing number of staff are out sick because they were infected by or exposed to COVID-19, said Alabama Hospital Association President Don Williamson.
He said many Alabama hospitals were already short-staffed before the pandemic.
“Right now, we are in a very worrying position, and I think an increasingly unstable position relative to COVID,” said Williamson, adding that the state’s 7-day average for hospitalizations has nearly doubled in the last five weeks.
Choctaw Hospital in Butler is short five nurses and a lab person, said Cowan. Several of the hospital’s nurses are at home with COVID-19. Two may never return because their illness was so severe. Yet it’s not easy to bring in reinforcements.
Williamson says he’s spent hours this week on the phone with hospitals who face staffing shortages to treat the influx of COVID patients. Some, like University of Alabama at Birmingham, are not facing an immediate staffing shortage.
“(Most nurses) want the glamor and lights of Birmingham, Mobile and Tuscaloosa. They don’t want to come to Butler, Alabama,” said Cowan.
Hospitals in larger urban areas have a shot at competing for traveling nurses in a nationwide bidding war that has driven up nursing salaries during the pandemic surge, sometimes drawing nurses in-state away from smaller, rural hospitals to higher paying gigs in cities.
The first six weeks of the state-mandated moratorium on elective procedures this spring cost Alabama hospitals $739 million, according to Williamson.
However the rising demands of COVID-19 are addressed, he said, it is inevitable that cases will continue to rise this winter, surpassing the surge in the spring.