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A nurse's view as three viruses send Americans to hospitals

ARI SHAPIRO, HOST:

Health care workers who've been on the frontlines of the pandemic for close to three years now are entering a new chapter. Hospitals are filling up with people who are sick from three different diseases - the coronavirus, the flu and a respiratory disease called RSV. Grover Nicodemus Street is a traveling nurse who we've been checking in with since early last year.

GROVER NICODEMUS STREET: I really do want to retire. You know, I want to spend - I don't want to get coronavirus and die. But what goes through my mind is - I've seen a lot of doctors and nurses and health care workers quit because they can't handle it. And if we have all these health care people quitting their jobs, who's going to take care of all the sick people that come in the hospital?

SHAPIRO: That was March of last year. Well, he has not retired and is now assigned to a hospital in Northern California, where he's paused a busy workday to bring us up to speed on what he's seeing. Grover Nicodemus Street, good to talk to you again.

STREET: You as well, Ari. It's been a rough year.

SHAPIRO: Yeah. And what have the last few weeks been like?

STREET: Over the last two years, COVID was the dominant virus making everyone sick. And then there was essentially no influenza, so everyone's immunity was down and is still down. This year, Influenza A, something that our immune system is not used to, is taking the U.S. by storm. And I'm sure it's overseas and everywhere else. And RSV is on the rise. Usually RSV is in kids, in children, but we're seeing it in adults as well. And then COVID is sneaking its head out again.

SHAPIRO: And what does that mean in terms of the actual hospital where you're working? Like, are beds full? Is there capacity for the surges that we're in the middle of?

STREET: I'm working in a critical access facility, you know, a smaller hospital. This is a smaller community, more close-knit, family kind of oriented hospital. It's easier space to work in. But, you know, putting all that to the side, it's like being in a big hospital in a little space because it is to capacity. We have to transfer patients out. And when we call out to other facilities to see if they have space, it used to be they didn't have enough staff working. And now it's the space. It's like, we don't have any beds. All of our beds are full, and we have people in the halls.

SHAPIRO: Let's talk about the staff situation because as we heard, you were warning about health care retirements more than a year ago. There's a national shortage of nurses. What does that mean for the patients who need care?

STREET: It's awful. There's something called nurse-to-patient ratio. And when you work outside those ratios, it becomes unsafe for the patient and for the workers because of job fatigue and medication errors and different things that can happen in the process. So...

SHAPIRO: Just to pause for a minute, when you talk about that ratio, what does the ratio look like right now? Like, how far is the patient load outside of the recommended ratio?

STREET: OK. So the normal ratio - it depends on the area of nursing you're in. An ICU is usually 2-1 or 1-1. That means two patients for one nurse or one patient for one nurse. In the emergency room, it's usually 4 or 5-1. And we're working with ratios in, you know, 8-1...

SHAPIRO: Wow.

STREET: ...Six to one. It was like during COVID, when COVID hit. Those ratios are starting to climb where we're having to take care of more patients with less staff.

SHAPIRO: And what does that mean for you as somebody who might already be feeling a degree of burnout and PTSD after the last two years?

STREET: I'm not. I feel great. I stay in the gym. I work out. I try to keep my head sharp. I eat right. And I think doing all the stuff I do outside of work, it helps prevent that burnout. And...

SHAPIRO: Yeah.

STREET: I'm so used to it, you know? When I was in Miami - you didn't catch me in Miami, but I did 100 hours a week for 45 days straight, and I still went to the gym and worked out for an hour a day. You have to dig deep within inside yourself and know that this is your job and desensitize yourself to the issue at hand and take care of your patients and leave it in the hospital.

SHAPIRO: You're talking about these patient ratios of six or eight patients to one nurse. We're still early in flu season. I mean, officially, winter hasn't even started yet. Are you worried about what the next few months might bring?

STREET: Oh, absolutely. It's - and my wife - she's a physician. She's actually in charge of a group of 400 doctors. And she talks to me all the time about what's going on in other facilities. And people are getting sicker. The hospital census are going up. This is early. Like you said, this is early on. Winter hasn't even hit. When winter hits, it's going to be a lot worse than it is now.

SHAPIRO: And so if people listening to this are planning on going to holiday gatherings, meeting up with family, maybe traveling, what advice do you have for them?

STREET: Flu shots, vaccinations - vaccinate, vaccinate, vaccinate. It's been proven. I mean, if it can help you 30% from getting the flu, that's better than nothing. And then hand-washing is the mainstay in health care. Wear your mask, and just don't get sick.

SHAPIRO: It has been more than a year and a half since you told us you intended to retire. You're still at it, working more hours a week than I typically work in two weeks. How are your retirement plans going?

STREET: You know, people at the hospital I'm working at currently - it's like, yeah, I'm retiring. This is my last assignment. I tell everybody that. And then I talk to my wife. I was like, I can't see myself not working in the hospital. You can do this on into your 90s and until you're 100 years old if you know how to do it. And this is my profession. I'm a pro at what I do, and I love my job. And the biggest thing - you have to love people to do what we do.

SHAPIRO: And when your colleagues say, I can't keep it up; this is too stressful; it's too difficult; this situation is untenable, what do you say?

STREET: I say everything in life is only temporary, even this 12-hour shift. We'll get through it together.

SHAPIRO: Travel nurse Grover Nicodemus Street is author of "Chasing The Surge: Life As A Travel Nurse In A Global Pandemic." It's always good to talk to you. Thank you for the work you're doing and for telling us about it.

STREET: You too, Ari. It's always nice. Transcript provided by NPR, Copyright NPR.

Alejandra Marquez Janse
Justine Kenin
Justine Kenin is an editor on All Things Considered. She joined NPR in 1999 as an intern. Nothing makes her happier than getting a book in the right reader's hands – most especially her own.
Ari Shapiro has been one of the hosts of All Things Considered, NPR's award-winning afternoon newsmagazine, since 2015. During his first two years on the program, listenership to All Things Considered grew at an unprecedented rate, with more people tuning in during a typical quarter-hour than any other program on the radio.