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‘It Just Seems Neverending’: A Nurse In Pearsall Talks About Keeping Rural COVID Care Going Amid Burnout

Spencer Selvidge for KUT
Andrea Malcolm of Frio Regional Hospital says the emergency department has helped out with the care of critical COVID-19 patients because of staffing shortages elsewhere in the hospital.

“We get through a surge and we think, OK, we’re done. And then a year later, we’re in another surge. And all we can think of now is, when’s the next one going to come?”

From Texas Standard:

Hospitals and health care workers across the state are feeling the strain from this latest surge of the coronavirus.

Andrea Malcolm is a certified registered nurse anesthetist at Frio Regional Hospital in Pearsall, a 25-bed critical access hospital with a 24-hour emergency room, about an hour outside of San Antonio. It's the only hospital between San Antonio and Laredo, and she told Texas Standard health care workers there are experiencing severe burnout.

"It just seems never-ending," she said. "We get through a surge and we think, OK, we're done. And then a year later, we're in another surge. And all we can think of now is, when's the next one going to come?"

Malcom says that seemingly endless cycle is making it hard for staff to keep up with patient demand. Her hospital already runs on limited staff, and now it's seeing quadruple the patients because of COVID-19. And critical care patients require one-on-one nurse care, so that makes the shortage even worse.

"It's difficult to just find four times the nurses that you're used to having," she said.

Malcolm also believes it's driving thousands of people out of health care professions in Texas.

There are some improvements since last January's surge, however. Malcolm says her hospital has leaned on its emergency room staff to take critical care patients who need help around the clock. COVID-19 treatment is also better; she estimates the death rate for patients hospitalized for the disease has gone down dramatically.

But there's also a sense that others have moved on even though the pandemic is still raging. Help with supplies and staffing from the federal government isn't available like it was last year. Malcolm says her hospital now has to rely on the state for help, which is "about half" of what it was in past surges. Plus, the generally public seems weary. Vaccinations are likely helping reduce hospitalizations, or at least making them less severe, but when it comes to masks in her area, she says about half of people wear one.

"You're seeing about 50/50 people implementing those measures on their own, out of precaution," she said. "But I think people are to a point now where they say, they have to live their life. And I think they're at a point where they know they're going to have to live it around this virus."

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Michael Marks
Caroline Covington is Texas Standard's digital producer/reporter. She joined the team full time after finishing her master's in journalism at the UT J-School. She specializes in mental health reporting, and has a growing interest in data visualization. Before Texas Standard, Caroline was a freelancer for public radio, digital news outlets and podcasts, and produced a podcast pilot for Audible. Prior to journalism, she wrote and edited for marketing teams in the pharmaceutical and cosmetics industries. She has a bachelor's in biology from UC Santa Barbara and a master's in French Studies from NYU.
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