The recent surge of COVID-19 infections due to the delta variant has stressed health care systems across the country, but in some areas, a rare summertime epidemic of respiratory syncytial virus (RSV) has exacerbated the situation.
"We had very little time to react because the numbers of both RSV and COVID-19 went up so quickly," says Mark W. Kline, M.D., physician-in-chief and chief academic officer at Children's Hospital New Orleans and professor of pediatrics at Tulane University School of Medicine. "We were near a breaking point."
Creative solutions to staffing issues
The primary challenge leading to a near breaking point was finding enough nurses to care for the patients streaming into its facilities. Like many children's hospitals across the nation, Children's New Orleans faced staffing shortages even before the pandemic's onset. COVID-19 has amplified those shortages—there are currently 6,000 open nursing positions across Louisiana—so bringing in new staff members is a challenge. "Everybody is competing for the same pool," Kline says.
The problem required some unconventional thinking and led Kline to seek an in-house solution. "We were already short on staff nurses, so we've ended up pulling nurses from administrative positions, we've pulled nurses from our outpatient clinics and nurses who have past inpatient experience," Kline says. "You have to think creatively and do the best you can."
Shorthanded, but "not willing" to choose alternative
Though not ideal, Kline says pulling nurses from other posts was much better than the alternative. "We found nurses everywhere we could find them to staff full beds, but we've been right at that tipping point where we were out of ideas and options of how to staff any additional beds," Kline says. "The alternative for us was to go on drive-by or diversion, which meant sending kids to other hospitals, and we weren't willing to do that."
Children's New Orleans serves a large area across the Gulf south region, the hospital's leaders felt compelled to find ways to care for the children who needed them, according to Kline. "As is true in a lot of parts of the country, kids don't have very many options," Kline says. "We're the court of last resort for the kids who are most seriously ill and have the most complex problems, so when we say we're on diversion, where do they go?"
Read more from Kline about how the current COVID-19 surge differs from previous waves of the virus and how children's hospitals can prepare.