With the third-worst hospital staffing shortage of any state in the country, South Carolina's health care leaders are finding they must turn to creative solutions and rely on outside help during COVID-19.
As the state manages a long winter with thousands of new coronavirus cases each week and tries to implement the most aggressive vaccination campaign in its history, people are proving to be one of the hardest resource to hold onto.
Thirty-six percent of South Carolina hospitals are seeing staffing shortages, according to the latest weekly report from the White House. That compares to 16 percent nationally, and puts the state behind only New Mexico and California.
It has led the state's hospitals, and even the state public health agency, to call for volunteers, especially those with health care experience. Some are also hiring temporary staff as organizations manage vaccines and COVID-19 on top of their usual business.
It's not only hospitals that are feeling the squeeze. Charleston-based Liberty Doctors is one of the only independent primary care offices to get the Pfizer vaccine, which must be stored at ultra-cold temperatures. Its leaders felt it important to be able to offer the inoculation directly to their patients.
Dr. Hugh Durrence, a family physician with Liberty Doctors, said the practice's vaccination effort runs on volunteers. And though doctors' offices are not paid much to vaccinate, Liberty Doctors has also hired help.
"We've modified our practice to accommodate the pandemic," Durrence said.
Help on the way
Though the shortage is severe, South Carolina has people to fill in the gaps, including a force of volunteers eager to help and a reserve force of soldiers that has been sent to every corner of the state.
The S.C. National Guard has about 50 medics available. In total, about 480 soldiers are on duty in order to support the guard's COVID-19 missions.
Maj. Gen. Van McCarty, the state adjutant general, said the focus of the guard was supporting testing sites for most of last year. But with COVID-19 cases persistently high during the winter and the statewide vaccination effort ramping up, needs have shifted.
"When we began to see a significant number of our hospital utilizations throughout the state growing, and the hospitals also experiencing personnel shortages, we shifted to providing our medical support to help hospitals," McCarty said.
The National Guard is focusing on being a "force multiplier," McCarty said, strategically supporting as many operations as it can. But the guard is naturally limited in its capacity, too.
Any exposure to the coronavirus, at home or at work, causes a staffing shortfall because of the need to quarantine, McCarty added.
The arrival of the vaccine and the fact that health care workers were first in line is beginning to alleviate that problem.
Dr. Danielle Scheurer, chief quality officer at the Medical University of South Carolina, said about 80 percent of MUSC Health staff who interact with patients had been vaccinated by the first week of February.
"We do like to think that reaching that amount at least makes the workplace safer," Scheurer said.
The number of new infections among people who care for patients at MUSC has dramatically fallen in recent weeks as a result, Scheurer said, a huge relief and success for the hospital system.
Even so, MUSC had to request $5 million in aid from state legislators to help it retain and hire staff as it faces a shortage of 1,500 nurses.
A persistent problem
Though convincing nurses and other health care staff to stay in South Carolina is a problem exacerbated by COVID-19, the state was already having trouble keeping them.
Jeannette Andrews, dean of the nursing school at the University of South Carolina, worries that even as educational institutions like hers push to send more people into the workforce, the stress of being on the front lines of a pandemic is encouraging staff to leave their professions early.
"We've got to not only continue to produce the supply for the shortage, we have to be attentive to potential attrition that may occur," she said.
And so the struggle to combat the state's workforce shortage only grew more complicated during COVID-19. Pre-pandemic, South Carolina already had one of the most severe nursing shortages in the country. Pay appears to be part of the problem.
Not accounting for the cost of living, the average hourly wage for registered nurses in South Carolina is $5 below the national average, according to data from the Bureau of Labor Statistics.
Wages here have also been more stagnant, growing only 8 percent between 2010 and 2019, compared to 14 percent nationally.
The pay issue is a complex one, Andrews said. Educators are not paid enough to make leaving the bedside for a teaching role worthwhile, for one. And the travel contracts that are pulling many people away from the state offer much higher pay than what most organizations can afford.
At the request of Prisma Health, the state's largest hospital system, dozens of USC students each day are volunteering, Andrews said.
Karly Taylor, a third-year nursing student, is one of them. Taylor volunteered recently at a Prisma Health mass vaccination event, where organizers needed plenty of logistical help moving everyone through the lines.
"They need the manpower in order to be able to make this run smoothly," Taylor said. "There's hundreds of people at these vaccination sites at all hours of the day. Everyone's making their best effort to make sure that people get vaccinated."