Texas Nurses Worry About Quality Of Care As COVID-19 Spreads

The Texas Nurses Association warns that if health care professionals are being stretched too thin, the COVID-19 death toll could increase.

A registered nurse holds her gloves before making her way to a patient’s room inside the Coronavirus Unit at United Memorial Medical Center, Monday, July 6, 2020, in Houston.

When U.S. Sen John Cornyn on Sunday needed some clarity on the spread of COVID-19 in Texas, he took to Twitter.

"Maybe someone can explain why Houston has significantly more cases of #COVID19 reported than Dallas, but nearly identical number of fatalities," the senator tweeted.

The responses came flooding in, many from critics of the senator who accused him of being "conspiratorial," while others said he has not done enough with his position to help.

But it was one of those responses, from a nurse in San Antonio, that caught most peoples' attention.

The nurse, Shelly, said Cornyn did have an opportunity to have his COVID-19 questions answered, on an April 16 conference call in which several nurses detailed their own experiences in Texas hospitals. But the senator did not attend. Instead, a staff member joined the call.

"We were pleading for help," Shelly told Houston Matters Special Edition host Ernie Manouse on Tuesday. " I didn't really get to tell my story because the assistant that took the call pretty much said, ‘time's up, call's over.'"

It was a response that frustrated Shelly, 33, who declined to give her last name in the interview. The nurse said she's especially fearful now for nurses in Texas hospitals, because thanks to a recent surge in COVID-19 cases across the state, personal protective equipment may again start to be in short supply moving forward.

That's how she fears she originally caught the virus.

"It's literally like sending soldiers to battle with no armor," she said.

As hospitals reach capacity across Texas, it's frontline workers like nurses who have some of the most difficult jobs — and who fear they may be stretched too thin as the upward trend in COVID-19 cases threatens to drain resources and lead to an increased mortality rate in Texas hospitals soon.

The mortality rate of COVID-19 patients in Harris County is still less than 2%, according to the Centers For Disease Control and Prevention. But some experts fear it's a "lagging indicator," and that the surge in patients hospitalized since Memorial Day may start to affect that number soon.

While Mayor Sylvester Turner said Monday that Houston hospital bed capacity is on track to be overwhelmed in roughly two weeks, health care professionals are warning that they're already being stretched too thin, which could impact the care the patients in those beds are getting.

"We will start to see the death toll increase when our ability to provide that high quality care has been taken away because we just can't handle the sheer volume of patients walking through our doors," said Serena Bumpus, director of practice at the Texas Nurses Association.

There are more than 500 patients in Texas Medical Center ICU beds, according to the Houston Health Department. Hospitals can only do so much with what they have, and if they don't have the staffing to provide the care, mistakes can happen, Bumpus said.

Additionally, caring for a COVID-19 patient in the ICU is different from caring for a non-COVID-19 patient. Some Houston nurses who may lack the proper training may end up providing care for COVID-19 patients in order to meet the demand, Bumpus said.

"We don't have enough doctors to take care of those patients," she said. "So then you move into what's called a crisis staffing situation, where your pulling nurses from other areas of the hospital, out of the operating rooms and into the recovery room area, and deploying them into these makeshift ICUs, where they are now caring for these patients who are in a critical status."

"They're stretching an ICU nurse's knowledge to care for more patients," Bumpus added."That's not the type of care we necessarily want to provide."

That, in turn, leads to more tired nurses, and worse morale.

"More and more people are coming in and staying and working extra, and those long exhausting hours take a toll on your body, Bumpus said."

One reason nurses are having to work more, Bumpus said, is because a higher number of them are contracting COVID-19 from treating patients with the virus.

One of those is Shelly, who told Manouse on Houston Matters Special Edition that part of the reason she wanted to speak to Cornyn was to share that very story.

"I'm a 33-year-old healthy nurse," Shelly said. "I catch the flu every winter and this was not the flu…This had me bedridden for months."

Reached for comment, a press secretary for Cornyn confirmed that the senator was not on the call, but added he did meet with "another large group of Texas nurses recently."

"Our staff member who spoke with (Shelly's) group, answered all of their questions, asked several of his own and invited them to follow up afterwards if they had more questions," the press secretary said. "Sen. Cornryn supported billions in resources for Texas nurses in the last relief bill, and will fight for more in the next one.”

Nurses aren’t the only ones sounding the alarm about the uptick in COVID-19 cases. Houston-area doctors have publicly worried about the quality of care they’re able to provide as the number of hospitalizations grows.

But In Houston, Bumpus, of the Texas Nurses Association, said the city was already facing a shortage of nurses before the pandemic, even as city officials say they are actively seeking more nurses to treat COVID-19 patients.

According to one model from the Texas Center for Nursing Workforce Studies, the Gulf Coast region of Texas will have a greater than 15% unmet demand in licensed nurses.

That's the highest projected unmet demand in 2030 for any region in the state.

"There is a shortage of nurses across the entire state of Texas," Bumpous said. "By 2030, we're expected to be short over 60,000 nurses in the state alone."

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