Clark County hospital insiders confirm staffing crisis amid pandemic

During a recent staff huddle at the start of her shift, operating room surgical technician Erika Watanabe observed what was once unthinkable.

“It’s finally happened. There’s no health care workers to take care of the public,” Watanabe, who works at Las Vegas-area hospitals owned by HCA Inc., said on Thursday of the dwindling ranks of colleagues amid the current coronavirus surge.

“Everybody’s sick,” many with COVID-19 but others with flu-like illnesses, said the union steward, who talks often with personnel in other departments experiencing shortages.

Staffing at area hospitals, which has been stretched thin throughout the COVID-19 pandemic, was declared at crisis levels in Clark County as well as rural parts of the state on Wednesday by the Nevada Hospital Association.

The association and hospital representatives say that what has taken the shortage to crisis proportions locally has been health care workers contracting COVID-19 and calling in sick.

This has occurred as cases of the omicron variant have surged and as hospitalizations have increased.

Omicron, which has rapidly become the dominant strain across the country, including in Nevada and Clark County, spreads more easily while generally resulting in milder illness than the previously dominant delta variant. The mutant also has shown increased ability to infect those who are vaccinated or have immunity from prior infection, though they typically get less sick.

Dr. Jeff Murawsky, chief medical officer of HCA’s Far West Division, said that as of Thursday, 300 employees were out sick from the three Las Vegas-area HCA hospitals: Sunrise, MountainView and Southern Hills. That’s three times the typical number during the pandemic and six times the pre-pandemic norm. These figures also include employees who might be ill with COVID-19 and are getting tested.

‘Exacerbation of an underlying problem’

“Yes, we’re in a crisis,” he said. “Nevada’s been short of health care workers of all types for a very long time, and so this is just an exacerbation of an underlying problem.”

To address the crisis, the hospital group has canceled elective surgeries and put new restrictions on hospital visitation, he said. Managers also have been reassigned to provide direct patient care.

“We’re going to be there for our patients no matter what,” he said.

At University Medical Center in central Las Vegas, about 200 employees were out sick Thursday among the large hospital’s 4,000 staffers, a number that CEO Mason Van Houweling believes would be far higher had the hospital not mandated vaccination for its staff and gotten 99 percent compliance.

“It could have been a heckuva lot worse,” he said.

UMC also is postponing nonessential surgeries and restricting visitation, he said. It has hired 95 traveling nurses to supplement its workforce.

However, hospitals say it’s increasingly hard to hire travelers because the demand is high across the country.

“It’s a crisis right now,” Van Houweling said. “I’m not going to mince words.”

Seeking state help

The hospital association has requested assistance from the state to bolster the workforce in Clark County and other strapped parts of the state.

Discussions of what shape this assistance might take are ongoing, said Van Houweling, who also is chairman of the association’s board. However, he and Murawsky believe aid likely will come primarily in the form of non-medical workers filling in for employees in areas such as patient transport, food service, security and maintenance. The Nevada National Guard and the state’s volunteer medical corps are among the groups that could be called upon.

The state is meeting with Clark County Emergency Management, the hospital association and hospitals “to discuss the issues to find solutions,” Tim Robb, a representative of the governor’s office, said in an email.

Amy Shogren, a hospital association representative, said in an email that the trade group is working on ways to “help bolster the nursing pipeline in the future.”

The association’s crisis declaration appears to give hospitals the ability to loosen COVID-19 protocols, allowing hospital workers who test positive to stay on the job rather than requiring them to isolate at home. The change, based on new guidance from the Centers for Disease Control and Prevention, allows hospitals in crisis mode to set aside requirements for workers with COVID-19 to isolate for five days. However, both UMC and the HCA hospitals continue to require sick employees to isolate for five days and have not adopted the crisis protocols.

ER no place for worried well

Hospital representatives said that the strain on hospitals is being compounded by people with mild respiratory symptoms — or no symptoms at all — flooding emergency departments to get tested for COVID-19.

Those who simply want a test should go to a testing site, representatives said. If people are not seriously ill but want treatment, they should seek care from their doctor or an urgent-care facility, but not an emergency room.

“We understand lines at these public testing sites are long,” Gordon Absher, a representative of St. Rose Dominican hospitals, said in an email. “Actions are being taken to increase that capacity. But seeking a COVID test at an ER to rule out a possible exposure takes doctors, staff and other critical resources away from patients with urgent concerns like strokes and heart attacks.”

Hospital representatives urged more members of the community to get vaccinated. Those who are unvaccinated become the most severely ill from COVID-19, filling intensive care units and straining hospital resources.

“The more vaccinated our community is, the less strain on our health care workers and health care system going forward,” Murawsky said.

Watanabe went a step further. “When I see people refusing to wear masks, it’s like, come on. It’s a simple mask,” she said.

“And now your health care workers are getting sick.”

Contact Mary Hynes at mhynes@reviewjournal.com or 702-383-0336. Follow @MaryHynes1 on Twitter.