‘There’s no more staff’: Wisconsin hospitals in crisis mode as pandemic fatigue drives staff away

"Part Two: The Staff" highlights the staffing shortages at hospitals across Wisconsin, continuing our series inside the ICU, ER and inpatient facilities at SSM Health Monroe Hospital

MONROE, Wis. — In Wisconsin, the hospital bed crisis is a staffing crisis.

Twenty months into the pandemic, the rate of staff departures started rising after last fall’s surge, a state organization says. Now in the midst of another surge where COVID hospitalizations have jumped from about 100 in July to about 1,700 currently, those departures are taking their toll.

At SSM Health’s hospital in Monroe, they didn’t need to staff pre-pandemic for more than a 60% occupancy. For the last several months, they’re now consistently operating far above the capacity they have staff to cover.

“Our census right now is about 50% higher than we’re staffed to manage. Yet there are no more staff,” hospital president Jane Curran-Meuli said. “Our ICU is 2-3 times higher to what we’re staffed to, and there’s no more staff. So we have to keep figuring out every day, how do we do it differently?”

For the nurses left behind as they watch their colleagues depart, the emotional toll is immense as they fight what at times feels like a losing battle for their patients.

RELATED, Part One: ‘Trying to keep our heads above water’: Inside the hospital bed crisis in rural Wisconsin

“It’s hard to see people go, especially when you develop relationships with them,” inpatient registered nurse Jeanette Williams reflected.

Medical staffing shortage in Wisconsin predates pandemic

Even before the pandemic, Wisconsin’s aging population has long needed higher levels of care from its clinics and hospitals. In a 2020 report, the Wisconsin Hospital Association reported a corresponding rise between 2013 and 2019 of full time staff employed in Wisconsin hospitals, but also reported a “silver tsunami” where people were aging out of the healthcare workforce faster than they could be replaced.

In the 20 months since the pandemic hit Wisconsin, the healthcare system is still grappling with how to meet the heightened demand with staff that are now leaving at higher rates out of burnout or for better-paying jobs.

According to the Wisconsin Hospital Association, staff departing from health care jobs rose by 30% during the five months immediately following the fall 2020 surge.

That’s compared to fewer than 2% of staff impacted by vaccine mandates coming later in 2021 for many health care providers around Wisconsin, WHA spokesperson Kelly Lietz said. SSM Health was the first health care provider in Wisconsin to announce a vaccine mandate for staff, and also had one of the earliest compliance dates.

When the mandate went into effect on October 1, SSM Health facilities in Wisconsin had more than 99.8% compliance statewide.

“Hospital vaccine policies are not what is causing nearly two years of COVID strain and stress on hospitals and their staffs,” Lietz noted in an email to News 3 Now. “In addition to the workforce challenges plaguing all industries right now, the perpetuation of this pandemic has caused far more people to leave the health care workforce than vaccine requirements.”

Stress, higher-paying jobs are major factors

At Monroe Hospital, Curran-Meuli says they can’t compete with the high wages that nurse traveling agencies are currently offering. They’re losing staff, at times to those jobs; at other times–it’s burnout.

“Staff are being asked to pick up quite a bit of extra,” ICU nurse Janelle Jaeggi explained.

“We’ve lost a handful of people, honestly,” Williams reflected. “I think people are getting burned out and they’re looking for less stressful work.”

With six ICU beds filled constantly with COVID patients, and about half their inpatient beds also dedicated to them, the 55-bed hospital is often resorting to sending some patients into their family birth department or shuffling staff around between departments to cover for the gaps.

That’s putting staff in positions at times to care for patients or do procedures they don’t have as much familiarity with as others. Other times, it means redirecting the staff with experience in higher level care to places like the ER, where critical patients wait on beds.

Shortages come as bed space runs out

Statewide, hospitals have been battling bed shortages for weeks as hospitalizations rise and people come in sicker with conditions they’ve put off care for.

That’s even as the overall bed space across Wisconsin has increased during the pandemic. Last July, Wisconsin hospitals had 10,878 beds; as of October 31, that had increased to 12,768 beds to help keep up with the pandemic.

“Hospitals continue to do everything in their power to provide the beds and staffing needed, even as the demand for services strains the available workforce,” Lietz noted.

Part of the shortage is also connected to a lack of availability at step-down or longterm care facilities. Currently, the WHA said about 600 hospital beds are filled with patients who no longer need hospital care but have nowhere else to go.

“Six hundred essentially boarded patients waiting, sometimes for months, to be discharged to a nursing home, long term care or recovery facility, but there is nowhere for them to go, or they are not being accepted,” Lietz said.

The vast majority of COVID patients needed hospitalized care are unvaccinated: they are 11 times more likely to be hospitalized than the vaccinated if infected, and 12 times more likely to die, according to the latest data from the Department of Health Services.

‘That calling is being tested like never before’

For health care providers everywhere, the toll is immeasurable. First described as heroes early on in the pandemic, some say the number of patients who are critical or difficult has become harder to handle.

“Everyone was so much–‘Healthcare workers are the heroes,” Curran-Meuli reflected. “And that really seems to have settled down, and that isn’t put on that pedestal anymore. And I would say the majority of patients are so grateful for the care. But there are those patients that have been so incredibly rude, disrespectful, things you would not expect to see, especially in a community like this.”

Staff at Monroe Hospital are quick to praise most of their patients for their graciousness and patience as they strive to prepare the care needed. But still, the vocal minority are taking their toll, as medical staff are faced with skepticism and questions about their ‘integrity’, as one nurse put it, amid skepticism about the pandemic.

“Those who enter the health care field often describe their motivation to do so as a “calling.” That calling is being tested like never before. Hospitals and health care workers want people to know that while we all want to move on from COVID, their everyday reality continues to be filled with sickness and death caused by the virus, which continues to spread throughout our state at an alarming rate,” the WHA said.

Hospital leadership is trying to do their part. Many on the team reflect the support of their administration, and leadership recently hosted their Christmas dinner where hospital leaders serve up a holiday dinner to staff.

And for many, it’s the family-like support that keeps them going.

“We’ve spent holidays together for years, some of us who have worked here,” ER nurse Laurel Taylor said. “We are a family away from our family.”

When patients get tough to handle, it’s that family that will be there to provide support.

“We check on each other during work, after work–we always try to make sure everyone’s doing okay,” Williams said.

Photojournalist Brian Mesmer contributed to this report.

This is “Part Two: The Staff” of a multi-part series inside Monroe Hospital. On Thursday at 5, “Part One: The Beds” explored the hospital bed crisis