California nursing shortage becomes critical as coronavirus hospitalizations surge

Ten months into a pandemic that is getting worse, critical care nurses are being stretched thin and they need help. But there are few to be found.

As the coronavirus surge grows, so does the shortage of nurses, just as the state is under regional stay-at-home orders triggered by too few intensive care unit beds (see the chart below).

So what’s worse, too few nurses or too few beds?

“The issues are one and the same,” said Carmela Coyle, president and CEO of the Sacramento-based California Hospital Association. “People are measuring what our bed capacity is in our ICUs, and it's really not about the beds. It is not about bed frames and mattresses and pillows. It's not about space. It's about staff.”

The No. 1 challenge right now is a national shortage of nurses — something California didn’t have to initially contend with because the state surged early on and had access to traveling nurse agencies, which provide registered nurses and other health care workers to fill short-term needs.

And there’s the rub.

“What’s happened this time as California's second surge was later than the rest of the United States, all of those travel nurses are deployed elsewhere, largely in the Midwest and the mountain states,” Coyle said.

There’s also an additional piece to the puzzle this time around.

“Unlike at the very beginning, we now have staff who have contracted the virus themselves … who are quarantining, some who are sick, some who need to be home with their children who are doing online learning and all of the rest,” she said. “Simply the numbers of nurses available on any given day is fewer than it was at the beginning of the pandemic.”

That’s stressing Queen of the Valley Medical Center in Napa, which is operated by Providence St. Joseph Health.

“It's this constant juggling game of nurses that’s our big issue,” Dr. Amy Herold, chief medical officer of the hospital, told the Business Journal on Dec. 10. “That is really our challenge. And for a while we were in trouble because (Adventist Health) St. Helena hospital was still shut down.”

The Adventist hospital reopened Dec. 8 after being temporarily closed for more than two months after the facility was damaged in the Glass Fire.

At NorthBay Healthcare, which operates two hospitals in Solano County, “the greatest challenge of late is staffing,” Steve Huddleston, vice president for public affairs, told the Business Journal on Dec. 10. “There simply are not enough on-call and ‘traveling’ ICU staff available to fill shifts when we have absences.”

NorthBay Medical Center, located in Fairfield, has 24 licensed ICU beds, and six at NorthBay VacaValley Hospital in Vacaville, Huddleston said.

“We put in place a surge plan months ago that identifies how we can create more bed capacity for intensive and critical care of patients,” Huddleston said at the time. “However, we do not know if there will be sufficient staff to care for patients should cases continue to skyrocket.”

On Dec. 17, 54,000 Californians tested positive for the novel coronavirus, Coyle noted.

“What we know is 12% of those who are COVID-positive are in need of hospitalization two weeks later,” she said at the time. “That means two weeks from now, in a single day, there will be 6,500 Californians in need of hospital care.”

As of Monday, California had 2.12 million confirmed cases of COVID-19, resulting in 24,220 deaths. The number of COVID-related deaths increased by 1.0% from the prior day, according to the state.

“We cannot dodge the math,” Coyle said. “And that is why we're asking everyone to do their best; stay masked, stay physically distanced and stay home so that we can stop the spread of the virus in the first place, and unnecessary illness and death for Californians.”

Cheryl Sarfaty covers tourism, hospitality, health care and education. She previously worked for a Gannett daily newspaper in New Jersey and NJBIZ, the state’s business journal. Cheryl has freelanced for business journals in Sacramento, Silicon Valley, San Francisco and Lehigh Valley, Pennsylvania. She has a bachelor’s degree in journalism from California State University, Northridge. Reach her at or 707-521-4259.

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