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COVID-19

Staff Shortages Add To The Strain As COVID Pushes Hospitals To Capacity

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As COVID-19 cases surge, hospitals say they can’t get enough staff to keep up. Gov. Greg Gianforte’s administration says it’s collaborating with hospitals as needs arise.

Last week, CEO of Billings Clinic Dr. Scott Ellner said his staff were struggling to keep up with the number of patients the hospital had.

“In a nutshell, we are at or over capacity with our latest numbers, particularly affected by the fact that we’re seeing a lot of unvaccinated COVID hospitalizations,” he says.

Ellner says the hospital has had limited success in obtaining traveling medical staff to help care for the overflow of patients. As hospitals compete for workers across the country, Ellner says the going rate for registered nurses ranges from $100 to $300 an hour. Last week Ellner said he needed another 60 to 70 clinical and non-clinical staff to keep up.

In late August, the hospital asked Gov. Gianforte’s office for National Guard assistance. Gianforte directed the National Guard to solicit volunteers, and 10 troops arrived Wednesday.

But patient numbers keep growing, and the hospital announced Wednesday it may start triaging patient care as soon as this week.

Here’s Chief Nursing Officer Laurie Smith during a press conference video posted by the Billing Gazette.

“Pulling in the crisis standards of care is something that we don’t take lightly. We’ve never activated that at Billings Clinic,” she says.

Billings Clinic is the only hospital to directly ask for National Guard assistance, according to Gianforte’s office. The Montana Hospital Association has generally requested help from the National Guard to keep critical supplies like oxygen flowing into hospitals as supply chain issues persist.

Brooke Stroyke, a spokesperson with Gianforte’s office, said in a statement to MTPR that hospitals need to make specific requests for National Guard resources and have been apprised of how to do so.

The governor has asked for volunteers from the Montana National Guard rather than ordering the deployment of troops. Gianforte this week praised the Guard, saying they have “consistently stepped up to the plate”. The state has called on the Guard numerous times this year to provide security at the presidential inauguration, fight wildfires, respond to the pandemic and assist in overseas missions.

The Montana Hospital Association has also asked the governor's office to leverage federal COVID relief dollars to help in the bidding for contract traveling medical staff statewide. Former Gov. Steve Bullock did that last fall, sending hundreds of nurses, respiratory therapists and other clinical staff to hospitals across the state.

Hospital Association CEO Rich Rasmussen says another statewide effort like this could help increase the number of traveling staff in the state.

“Certainly it would give us greater buying power as a state with 50 critical access hospitals — small facilities. And that buying power is always important for us. But we do recognize that every state is doing this,” he says.

Stroyke with Gianforte’s office says the governor is not considering a state contract for traveling medical staff because each hospital has unique needs. She says the state is instead providing hospitals with a list of staffing agencies to call and is helping hospitals cover sky-high prices for traveling staff by getting reimbursement through the Federal Emergency Management Agency.

Billings Clinic CEO Scott Ellner says that reimbursement doesn’t cover all the costs associated with traveling medical staff.

“The FEMA reimbursement really is tied into very specific COVID-related patient care. We need nurses who are caring for sick cardiac patients, sick patients with cancer.” he says.

Brian Bell is the CEO of Cabinet Peaks Medical Center in Libby. He says it’s hard for small hospitals with limited financial resources like his to win bidding wars for traveling staff in the first place. And finding permanent staff is just as hard.

“There are places out there that you’ve probably heard that are offering sign-on bonuses upwards of $60,000 to nurses, and we of course can’t compete with anything like that,” he says.

He adds his short bench of staff has been stretched to the limits. As large hospitals fill up, it creates a bottleneck of patients that can’t transfer out of rural care centers leading to capacity issues in places like Cabinet Peaks.

“Patients will never be not cared for. However, you may not get as much care as would normally be provided if we were to get into a situation where we just could not transfer anybody out,” he says.

Bell says he hopes the hospital won’t have to limit care for patients, but says the current surge of COVID and other hospitalizations shows no signs of abating any time soon.

Copyright 2021 Montana Public Radio. To see more, visit Montana Public Radio.