Los Angeles Hospitals Overwhelmed Amid Surge in COVID Cases
Nurses Scramble with the Spike as Some Morgues Fill Up
Cases of COVID-19 continue to surge in Los Angeles County, and nursing staff at hospitals are increasingly feeling the brunt of the increase. The situation is becoming “very scary, every day,” according to Violet Pineda, a registered nurse at a busy hospital. Pineda, who works at Kaiser Permanente's Los Angeles Medical Center said last week that nurses in her unit and the hospital as a whole are increasingly overwhelming as the situation in the county continues to worsen and more patients come in. Sometimes nursing staff cannot talk to each other, because they are on their feet nonstop for 12 hours, only sitting down to do charting.
“There are nurses who go to the bathroom just to cry, that's how overwhelming our situation is,” she said. She added when she takes her lunch break, she just “chews and swallows” to get back to work, as the demand is so great.
Pineda's story isn't unique for healthcare workers in Los Angeles County, where already busy hospitals have been hit by a growing wave of cases. ICU capacity is at 0.0%. On Jan. 4, the Los Angeles County Emergency Medical Services Agency issued a directive to EMS workers not to take people suffering from cardiac arrest to hospitals unless spontaneous circulation is achieved on the scene, citing the impact of COVID-19 on hospitals. During the first week of 2021, nurses I spoke with reported having more patients per healthcare worker, a staffing shortage as nurses get sick and fewer nursing assistants to help beleaguered workers. Meanwhile those inside hospitals are working 12-16 hour shifts dealing with growing caseloads. Healthcare workers report burnout, chaos and high levels of stress.
The situation in Los Angeles County, already bad with a steady increase in cases over the summer and fall, worsened at the end of 2020. The County reported more than 400,000 cases on Nov. 30; it passed 800,000 total cases on Jan. 2. Now 1 in 5 Angelenos who get tested for COVID-19 are testing positive, according to the County Department of Public Health. Statewide, more than 2,450,000 cases have been reported.
As of Jan. 11, 7,910 people are hospitalized with the virus, according to the Department of Public Health.
Some nursing staff are finding themselves having to take on COVID patients. Allysha Shin, a registered nurse in the neuroscience ICU unit at Keck Hospital of USC, said her unit was suddenly partially converted to receive COVID-positive patients on New Year's Day. Now the 16 nurses are trying to adapt to the changes and avoid cross contamination; rooms at one end of the unit are under special isolation precautions and healthcare providers must wear full PPE. Shin said that almost every day it seems like another unit at the hospital is being converted. Nurses on staff are hesitant to work extra shifts because of burnout and fear of exposure to the virus. She said that they have had to hold off on care for some patients, as there are not available beds or nursing staff for patients.
“We thankfully don't have patients lining up in the halls, but ambulances are being backed up,” Shin said. “I had to have a patient wait in the ambulance, sitting on gurney for unnecessary long time because we didn't have resources.”
Dr. John Margetis, an occupational therapist working in the COVID unit at Keck Hospital of USC said that there have been increased callouts from physicians and nurses who are getting sick, or fear they might be. Six units at the hospital are dealing with COVID patients and are nearly full. As such, a lot of nurses are working on floors they don't usually work on, helping with the influx of virus cases. “Everyone's a little on edge,” he said.
Nursing staff is also having to provide more support for patients, due to a block on visitors due to the virus. Pineda said that nurses are trying to talk to patients and help alleviate their fears during this surge, which is adding further stress and work to staff. Margetis, who works in helping patients come out of sedation after stays in the ICU, said that at the end of December they were seeing 1-4 admissions a day for COVID-19, now it's 4-10 a day. He added that in most cases people are able to transition out of the ICU into other parts of the hospital for recovery, but so many new cases keep coming in.
Whenever nurses come to work they don't know what to even expect, Pineda said. She added that when she gets home from a 12-hour shift she stays in her room as she doesn't know if she might potentially be exposing her family to the virus. Now she is “very scared,” she said. A patient she had been treating the last two days of December tested positive for the virus on Jan. 1. She has since developed a cough and headache. As of Tuesday, Jan. 5 when she spoke to me, she was waiting on results from a COVID test.
As of Jan. 11, the County reported 12,387 total deaths caused by the virus. Speaking last week, Shin said that her unit has not had a patient die of COVID-19 yet, but other units in the hospital have not been so lucky. The hospital recently ordered a refrigerated truck to sit out back, because the morgue is full, she said.
The situation in Los Angeles has been getting increasingly worse. County health officials have pleaded the public to stay at home and wear masks. They also rolled out new quarantining restrictions for travelers coming into the county. At the same time health officials and healthcare workers are bracing for spikes from events such as Christmas and New Year's Eve gatherings to anti-mask incidents at grocery stores and at evangelical gatherings in Echo Park and Downtown Los Angeles' Skid Row at the end of the year.
Shin said that nurses she knows are already past the point of burnout, and healthcare workers are still bracing for the holiday spike. She said that the staffing shortage is making it all harder to handle.
“We're already seeing signs of PTSD in nurses,” Shin said. “They're already mentally and physically worn down. Their spirits are broken.”