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PASCAGOULA, Mrs. — Bobbie Anne Sison was on her way to the hospital just before dawn when one of her top nurses received a panicked phone call saying she couldn’t come to work because her car overheated on the 63rd. At Pascagoula Hospital, the principal nurse hit the brakes, made a U-turn, and raced to get it.

“We have staff falling like flies from Covid, so there was no way I was going to leave her on the side of the road,” said Ms. Sison as she walked the corridors of her 350-bed hospital a few hours later. after a month of stagnation it is constantly being filled with Covid patients.

On Sunday, 106 coronavirus patients, a dozen or so sick earlier in the month, were treated at the Singing River Health System, a network of three small county-owned hospitals along the Mississippi Gulf Coast. With 40 percent of all Covid-19 tests in Pascagoula coming back positive and nearly 100 hospital workers sick, Ms Sison was trying not to think about what the coming days would bring.

“I don’t know if we can do this again,” he said.

Even new cases Peaks and declines in the Northeast and Upper MidwestThe nation’s hospitals still face an overwhelming influx of patients. In Mississippi, the latest wave of infections has forced nearly every acute care hospital in the state to work. capacity.

At Pascagoula Hospital, the city’s only acute care healthcare facility, a wave of departures left 80 unfilled gaps for registered nurses, forcing managers to keep their pulse on a third of their beds. By the end of last week, every remaining bed was full, resulting in an alarming backup system-wide. With nowhere else to go, coronavirus patients who were well enough to move to another unit in the intensive care unit had to stay in place. Also, several seriously ill patients were stuck in the emergency room who could not be transferred to the intensive care unit, where care was much more rigorous.

Lee Bond, CEO of Singing River, said the current surge has exacerbated a catastrophic workforce shortage that public hospital leaders and public health officials say will continue long after Omicron is gone.

“The real crisis we are facing right now is a fundamental shortage of nurses,” she said.

Healthcare workers on the nation’s forefront were working with smoke even before Omicron’s arrival. Successive waves of sickness and death left them exhausted and numb; almost one in five left the profession in the last two years. And they get angry – at patients who refuse to be vaccinated, at hospital administrators who don’t spend the money needed for care. safe nurse-patient ratiosand political leaders calling them “health heroes” while opposing mask and vaccine mandates that could dampen the new tsunami of infections.

For small, nonprofit safety net hospitals like Singing River, where millions of Americans sought care, labor shortages were particularly grim. Financially fragile even before the pandemic, these institutions were unable to afford the high salaries swayed by travel nurse agencies and major healthcare systems, further accelerating the loss of staff that threatened their ability to provide quality care. Travel nurses can earn more than $200 an hour, which is far more than the $30 earned by most staff nurses in Mississippi.

“Many community hospitals are wondering how they’re going to keep the lights on,” said Tim Moore, president of the Mississippi Hospital Association.

The financial distress was exacerbated by Mississippi and other southern states’ refusal to adopt Medicaid expansion. For Mississippi, that means an additional $600 million in annual federal aid. state economistand an additional 11,000 new jobs each year, mostly in healthcare.

Governor Tate Reeves and other Republican leaders, who dominate state government, have also resisted calls to devote a significant portion of federal coronavirus relief benefits to perks that could help prevent healthcare workers from leaving their jobs.

Kelly Cumbest, 45, a registered nurse who manages patient care in the emergency department, said she has received only one application for 24 open positions in her department in recent months. “It’s not just Omicron that worries us,” he said. “What scares us is that we don’t have people to deal with heart attacks, strokes and car crashes, and that’s something politicians and the general public don’t really understand.”

The personnel crisis at Pascagoula Hospital is not immediately visible to visitors. Doctors and nurses prank and scrutinize the day’s cafeteria fare as they enter and exit patient rooms. But flashing purple lights over half a dozen doors tell a different story: They signal a patient’s missed call—a request for water, help getting to the bathroom, or helping clean hands after they can’t wait any longer. .

Sometimes the need is more critical. Deborah Briggs, 64, a newly admitted Covid patient, had thrown off her oxygen mask in feverish agitation and was having trouble breathing. “I’m on fire,” gasped the three nurses, returning the mask to her face, and then lifting her into a position that would allow her lungs to expand further.

Teresa Phillips, one of the nurses, sighed and tried to explain the difficulty of handling the complex medical needs of so many patients with 25 percent fewer staff. “I want to make sure my patients are bathed, their medication is given on time, and their vital signs are constantly evaluated, but you can’t do that when you’re this nervous,” said Ms. Phillips, who has just returned to the hospital. He returned to work after fighting Covid for the second time.

Nearly every nurse at Pascagoula Hospital was touched when asked how they had endured the pandemic for two years. Caroline Olivera, 24, who took her first nursing job and described herself as a “baby nurse” when the pandemic began, wept as she described the physical exhaustion from endless overtime shifts and the emotional burden of so many deaths. “You know the expression ‘only the fittest survive’? Here is mine,” he said.

A similar decision is often heard among residents of Pascagoula, an industrial port city of 22,000 that is still recovering from the devastation caused by Hurricane Katrina. Despite the lowest wages and alarming vaccination rates in the country, a stubborn commitment to the community for a while went a long way in persuading many nurses to stay in the workplace. Only 46 percent of county residents are fully vaccinated.

That commitment began to wane during the Delta disaster wave last summer, when managers were forced to hire travel nurses for the first time.

After the delta wave receded, many decided that they could not resist the monetary temptation and began to leave in droves. Some took their jobs, allowing them to stay at home with their families in Mobile, Ala., 40 minutes away.

“You can’t blame them,” said Jessica Samples, a registered nurse and 14-year veteran at Pascagoula Hospital.

The departures had a dangerous knock-on effect, forcing the hospital to hire more travel nurses and threatening its already precarious financial situation. Hospital leaders say that on some days, about 80 percent of nurses in some wards work on short-term contracts.

Its CEO, Mr Bond, said that as a result, Singing River has spent an additional $30 million during the pandemic. Himself and other hospital officials, Pressure on Mississippi state leaders to use $1.8 billion a quarter of federal pandemic relief funds to provide $20,000 withholding bonuses to nurses who agree to stay in the state for two years. Lawmakers countered with a much less generous offer to fund bonuses of around $1,000.

With 2,000 vacancies for registered nurses and some poor health outcomes in the country, hospital administrators are concerned about Mississippi’s long-term prognosis. Mr Lowe, of the public hospitals association, said he feared residents would blame health workers for the substandard care they were experiencing, an antipathy that would drive more people away from the profession.

This dynamic was felt last week as Brandon Russell, 20, a certified nurse’s assistant, tried to stay calm as he tried to meet the needs of nearly a dozen Covid patients. Before entering each room, he was required to don a surgical gown, gloves, and two masks, even if the task was as simple as turning off a light. After leaving the room, all this protective equipment had to be removed. The process was repeated dozens of times a day. The job pays $10 an hour.

Mr. Russell, who has recently recovered from Covid, said the past few months had led him to abandon his desire to become a registered nurse. “I love my patients, but I’ll be honest with you, I’m ready to quit,” she said. “It’s no use when every nurse here tells me not to do that when I open nursing school.”

Such feelings are painful to Sison, 36, a nurse nurse who seems impossibly cheerful as she gathers her staff. In the past few months, he’s lost count of times he’s had to console coworkers who were irreparably depleted or who’ve had a quick succession of deaths. He said he had a nervous breakdown in a nurse’s office and later resigned.

“You’ve nursed to heal people, but there have been weeks when we felt like we lost more people than we saved during the pandemic,” said Ms Sison, standing in the hallway with a nurse. They began to remember some of the Covid deaths: the 18-year-old who gasped and pleaded for help; 27-year-old father, who left behind four children; The old man who breathed his last minutes before he came to bid farewell to his family.

“Yes, we signed up for it, but people still forget that we are human and we have emotions,” said Ms. Sison. “You try to check in at the door when you get home, but you can’t.” For Miss Sison, the losses were personal. She was 33 weeks pregnant in March 2020 when the epidemic hit Pascagoula, and after battling a mysterious illness for weeks, a baby boy was stillborn. Doctors broke the news the day the hospital admitted its first coronavirus patient. In the autopsy, it was determined that the death was probably caused by Covid.

Three weeks later, Miss Sison returned to work. “They were there for me,” he said of his colleagues, “and I wasn’t going to leave them at such a terrible moment.”

Just then, an overhead speaker began playing the familiar tones of Brahms’ lullaby. Paramedics running up and down the corridor stopped on the way. . One woman said the song marked the birth of a child at Pascagoula Hospital, a “rare moment of kindness”.

He reminded them of the days when the hospital played “Don’t Stop Believin’” every time a Covid patient was discharged. In a time of relentless darkness, the song was a source of joy and hope.

But that was before, when many at Pascagoula Hospital believed that science and dedication would eventually triumph.

“We thought we were going to beat this virus,” Miss Sison said, her voice hoarse. “We don’t play that song anymore.”