The fourth wave of COVID-19 sweeping across many parts of California is taking an emotional and physical toll on nurses and doctors in the hardest-hit regions.
The delta variant is spreading rapidly in communities where vaccination rates remain low. Hospitals are filling up with COVID-19 patients. Many are young and healthy; few are vaccinated. The surge is overlapping with a statewide shortage in nurses, stretching healthcare facilities — and healthcare workers — to the brink.
“It's too much,” said Marci Jensen, an intensive care unit nurse at Saint Joseph hospital in Eureka. “It's too much for any person right now.”
As an ICU nurse, Jensen described witnessing death and supporting families through their initial grief as part of the skillset her job requires. She knows how to manage shock and crisis. But the past few months have been different, as the delta variant began to spread across northern California.
“These patients are younger, and they're sicker than before,” she said. “And that's a very different thing in the ICU for me than I've experienced in the last decade.”
Saint Joseph’s is one of the only hospitals in the region equipped to care for people in need of intensive care. Patients from neighboring counties like Del Norte and Trinity, where the vaccination rates are much lower than in Humboldt County, have been flooding the facility.
“It's just back to back getting people in their 30s and 40s,” said James Ladika, a float nurse at Saint Joseph’s. “And it's absolutely overwhelming.”
Before this most recent surge, Ladika added, “you had time to space out the sadness.”
It’s a similar situation at Bakersfield Memorial Hospital, according to Sandy Reding, a registered nurse there and president of the California Nurses Association.
“To see younger people come in, maybe a 35-year-old with a family that's young, and to have to let them know that their loved one didn't make it, is very, very taxing on a nurse,” Reding said.
She added: “I haven't seen this much death in my whole 25-year career as I have this last year.”
COVID-19 has exacerbated an ongoing challenge for hospitals across California: hiring and retaining enough nurses. Communities in the Central Valley are among those where the shortage is the most acute. In the midst of the current surge across the region, nurses and doctors are struggling.
“A lot of our nurses are very stressed by the care environment,” said Dr. Susanne Spano, an emergency room physician at Community Regional Medical Center in Fresno, which has reached 112% hospital capacity. “We are losing some of our staff to less stressful jobs because emergency nursing right now is not the most fulfilling line of work.”
This week the California National Guard sent help to three hospitals in Fresno County and one in Tulare County. During the winter surge, the Department of Defense also sent help.
“We told the state that we’re still in deep trouble here in the Valley,” said Dan Lynch, director of emergency medical services in Fresno County.
Hospitals faced with staffing shortages have turned to travel nurses to meet their immediate needs to fill the gap. Last week, Gov. Gavin Newsom signed an executive order allowing nurses from outside the state to work in California.
But hiring traveling nurses is costly, and not a long-term solution the Central Valley community needs, according to Keri Noeske, vice president and chief nursing officer at Kaweah Health Medical Center in Visalia.
“To get 12 ICU nurses, it'd be $180,000 a week,” Noeske said. “If I need them though, I'm going to pay it.”
For the past year, Kaweah Health has had between 100 and 130 open nursing positions, Noeske said.
“Never before in my career have I ever seen nursing turnover rates, and like the ones that we're experiencing right now,” said Dr. Lori Winston, an emergency room physician at Kaweah Health’s hospital. “We need all the help that we can get.”
Dr. Winston said she encourages her colleagues to take time to rest and recover when they can — but the workload can be overwhelming.
“There's days where your cup is really full,” said Jensen, the nurse in Eureka. “I can personally attest to crying many a day in a supply closet or a stairwell because I just can't wait until I get home because my cup is full. And then I come home, I don't have anything to give my family because my cup is full.”
Watching patients who have not been vaccinated suffer has only exacerbated the emotional toll, Jensen said.
“You're just like why,” she asked. “This did not need to happen. This was so easy.”
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