As Florida’s coronavirus cases break national records, health workers say they’re feeling the strain. While most hospitals still have room to take in more patients, some doctors and nurses say they're being pushed to their limits.
Marissa Lee, 63, has one word to describe her work experience during the pandemic: chaos. She's been a nurse for more than 30 years and works in the labor and delivery unit at Osceola Regional Medical Center.
"I supposedly work at the ‘happy floor,’ but I've got to tell you, nurses on my floor have been exposed to COVID," she said.
Lee said some of her colleagues are getting sick, and she blames inadequate testing and protective gear, as well as relaxed restrictions in the community for the spread.
She said staff are told to reuse N95 masks for multiple shifts unless they get contaminated by fluids, and that workers typically only get tested for COVID-19 if they show symptoms, so asymptomatic people can slip through the cracks and keep working, exposing others.
When staff can't come into work because they're exposed, everyone else has to pick up the slack.
Lee said nurses are being floated to other units outside their scope of expertise and are being assigned to more patients than usual.
She said she can't always spend enough time supporting the mothers she's treating because she's running from one to the next. And she said her friends on the intensive care unit who are treating severely ill COVID-19 patients are in the same boat.
"Somebody is going to get neglected, and as a nurse, none of us want any patient to be neglected,” said Lee.
"Work until they drop"
The experience is taking a toll on Lee who said she recently had to turn down a request to work an extra shift.
"And I'm going, ‘Oh, my God, I'm so exhausted, do I need to go in and help my co-workers, am I going to be any good to them because of my exhaustion?’ " she said.
Emergency department staff have been dealing with these issues for months. And Dr. Angus Jameson, who works at Tampa General Hospital and is medical director of Pinellas County Emergency Medical Services, said it’s getting worse.
For example, state records show that since the pandemic began Pinellas County hospitals have treated 1,160 patients for COVID-19 as of Wednesday morning. Nearly half of those patients were admitted over the past few weeks, with 497 hospitalized now. The statistics are worse in neighboring Hillsborough County, where Tampa General is located, with 604 of the county’s 1,002 total hospitalizations in treatment.
Jameson told Pinellas commissioners last week that it will be hard for staff to maintain the pace.
“I have every confidence that our hospitals and our health care providers will work until they drop to help keep our community safe, but you should know that our hospitals are stressed and strained and so are your health care workers,” he said.
Help is on the way
Gov. Ron DeSantis is often criticized for his attempts to diminish the severity of the pandemic in Florida. While he's quick to emphasize coronavirus patients only make up a fraction of people in most hospitals, he has said supporting medical staff is a priority.
DeSantis is sending thousands of outside nurses to hospitals and nursing homes in need. Some have already been deployed to South Florida and the Tampa Bay region.
DeSantis told reporters at a press conference in Apopka last Friday that more help is on the way.
“Having this personnel is very important, so we’re supportive of that,” he said. “I also think the federal government is going to be sending some teams to supplement, and potentially the Department of Veterans Affairs.”
HCA, which operates 50 hospitals in the state, including Osceola Regional Medical Center, refuted Marissa Lee’s claims that staff don’t have enough PPE but said in a statement that “some 200 additional nurses have already committed to coming to our hospitals.”
“We continue to work with local emergency planning agencies and the Governor's Task Force to recruit more,” said spokeswoman Debra McKell.
This will all be a huge help, according to Justin Senior, CEO of the Safety Net Hospital Alliance of Florida.
“You don’t want to exhaust your staff, you don’t want to burn them out, you don’t want to stress them out,” he said. “You want to keep them fresh, you want to keep them focused, you want to keep them protected and you want to keep morale high.”
Senior said hospitals are adapting their space and workflow to accommodate the current rise in patients. Facilities in South and Central Florida, as well as the greater Tampa Bay region, have already rolled back on elective surgeries. But at a certain point these efforts may not be enough.
"You can declare surge capacity, you can create additional capacity, start doubling up rooms, but that's something you can only do very temporarily, or you're just not going to get the quality results that you need,” Senior said.
Jackson Health System in Miami has started moving beds into unused areas of the hospital as the city becomes the epicenter of the pandemic. At a recent press conference, CEO Carlos Migoya urged members of the public to do their part in supporting hospitals.
"If we can get everyone to be socially distant and wear masks, that's the only way we're going to be able to reduce the number of beds being used in hospitals and reduce the deaths that are happening in our community,” he said.
Nurse Marissa Lee agrees, but she said there's more to it.
At the federal level, Lee is pushing for Congress to pass the HEROES Act, which includes a provision that would require the Occupational Safety and Health Administration to issue emergency standards for workplace protection against COVID-19. The House-backed bill faces opposition from Senate Republicans, who are expected to unveil their own proposal this week.
At the state level, Lee said she would like to see the governor continue to bring in additional resources to relieve the pressure staff are feeling.
And she wants politicians and health care executives to listen to frontline workers when they say there’s a problem and not try to downplay the situation.
“We just want our voices to be heard,” she said.
And, she said, for those voices to spur action.