The U.S. seems to be headed into a "tridemic" this winter, as COVID, the flu and RSV overtake hospitals. And many nurses, who are already
The CDC reports approximately 40,000 new COVID cases and 2,000 deaths each week, as total deaths reach well over a million since the start of the pandemic over two years ago. To make matters worse, flu hospitalizations have hit a decade high and Respiratory Syncytial Virus, otherwise known as RSV, is seeing a record surge in pediatric hospitals. RSV is a common airborne virus that impacts the lungs and breathing passages, usually only causing mild cold-like symptoms. But the virus can take a much more serious toll on infants and children.
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"Now that everybody's back out, we're seeing a higher rate of transmission of RSV, the flu and certainly COVID-19," says April Kapu, president of the American Association of Nurse Practitioners. "So many of us already had family members, coworkers and patients die from COVID. We've been grieving while in the midst of a staffing shortage. There's just emotional, physical and mental exhaustion."
Kapu notes that between a lack of nurses and the growing number of tridemic cases, hospitals will be even more overburdened this winter. However, a strong nurse-to-patient ratio saves lives, with a study in the Journal of the American Medical Association finding that hospitals with one nurse to eight patients experience five additional deaths per 1,000 patients compared to a one-to-four ratio.
While the staffing shortage cannot be solved overnight, Kapu underlines that there are ways employers can support nurses and mitigate burnout. And it starts with listening.
"Nurses should have a seat at the table when decisions are being made about staffing and our work environment," says Kapu. "We should feel included, respected and heard."
Employers should also offer easy access to mental health services, such as grief counseling, so nurses know where to go when a loved one or patient they've become close to passes away, explains Kapu. Crucially, policies that limit working multiple days in a row can help nurses prioritize their health as well.
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"Nurses are notorious for putting ourselves on the back burner and putting patients first," says Kapu. "But we need time to refuel and recharge so we have the ability to come back and do what we enjoy — and that's caring for our patients."
Additionally, Kapu believes it's vital for more states to allow nurse practitioners to have full authority, meaning they can care for patients without a supervising physician. Washington, D.C. along with 26 states have given NPs this authority. Notably, NPs are required to have graduate degrees in advanced practice nursing and are able to assess, diagnose and treat patients. If nurses are able to manage their responsibilities without supervision, it will allow them to help more patients without running into what may feel like frustrating or even discriminatory barriers in their workplace.
"We've seen executive orders go into place throughout the pandemic that waived some of these outdated barriers," says Kapu. "We're hoping as we head into the winter, more states will update their laws so we can practice to the full extent of our education and training."
The U.S. public can also do their part to support nurses and minimize hospitalizations by taking precautionary measures: namely, getting vaccinated and masking up.
Kapu points out that only 22.6 million bivalent COVID boosters have been administered in the last few months despite hundreds of millions of Americans being eligible. The bivalent booster offers protection against the original COVID virus strand as well as the Omicron variant. The flu vaccine is seeing far better numbers, with 145.77 million doses distributed by the end of October.
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"COVID-19 is still very much here, and variants are still emerging. Not to mention, the flu has come into play earlier this year," says Kapu. "It's important everyone is vaccinated so we can hopefully have a better winter in terms of the severity of illnesses, hospitalizations and deaths."
Kapu encourages Americans to get vaccinated before the holidays, when it becomes easier to spread viruses to family members who may be especially at risk for hospitalization, such as children, those 60 or older and anyone with chronic health conditions.
Given that the flu, COVID and RSV spread via airborne transmission and droplets, masks are another important line of protection. Kapu advises anyone who is feeling sick to stay home, mask and ask others around them to mask as well. She also asks that Americans consider taking precautions in large, indoor gatherings. While masks are no longer required on planes, the CDC still recommends that anyone two years or older wear a well-fitted mask (such as N95s) on public transportation or in transportation hubs.
Kapu encourages people to check the
"If you're traveling, check that site," says Kapu. "And certainly, if you're in a large gathering, where you don't know anyone's vaccination status or if they're symptomatic, you would want to protect yourself by wearing a mask."
Kapu hopes the more the public does to mitigate the spread of viruses, the more hospitalizations and deaths the U.S. can avoid. Along with increased employer support, nurses may stand a better chance of enduring the winter tridemic.
"Get vaccinated and don't spread the virus at school or in gatherings," she says. "And if you're sick, reach out to your nurse practitioner."
