The recent spike in pediatric Respiratory Syncytial Virus (RSV) cases and other respiratory illnesses is overloading hospital emergency departments and forcing nurse leaders to adopt innovative staffing and logistical solutions.

Speaking at Tipton Health’s Special Nursing Leadership Webinar on managing the RSV surge, panelists representing children’s hospitals and a community hospital reported that their responses have been somewhat limited by existing nursing staffing shortages.

Joining moderator Pam Power, DNP, MSN, BSN, ACNS-BCD, ACNO, for the roundtable discussion were

  • Tara Buckenmyer, MHA, MSN, RN, NEA-BC, AVP of Nursing, Children’s Hospital at Montefiore
  • Annette Carlisle-Spotts, DNP, Manager of Care Management and Clinical Effectiveness, Norton Children’s Hospital, and
  • Vickie Taylor, RN, DNP, NE-BC, Assistant Chief Nursing Officer, Augusta Health

All panelists mentioned staffing – a problem even prior to the RSV outbreak – as their primary challenge. Montefiore’s Tara Buckenmyer, for example, said that the hospital was unable to implement some parts of its response plan, because it did not have the nurses available to stand up additional units.

Augusta Health, which does not have a dedicated pediatric unit, asked staff with pediatric certifications to take on Emergency Department rotations.

The panelists reported that they are also leaning on float pools, student nurses and apprentices, nurse educators, nurse practitioners, licensed practical nurses, and licensed vocational nurses to plug staffing shortages. 

Space & Supply Workarounds

The surge has also exhausted available pediatric beds or pediatric respiratory equipment, forcing nursing teams to find alternatives. The nursing team at Norton Children’s Hospital, in consultation with their engineering and equipment teams, is renting pediatric beds, cribs, pumps and other equipment as caseloads demand. Montefiore is sharing equipment across its various campuses.

Increased Communications

Each panelist mentioned the effectiveness of a “Daily Safety Brief” to bring together professionals in materials and supply, engineering, respiratory, nursing, and other disciplines to raise supply issues early – and thus, to resolve them early.

In the case of Augusta Health, the community hospital is connected to its peers across Virginia and relies on state-level communications to keep ahead of trends in outbreaks and supply shortages.

Addressing Burnout

The increase in RSV cases comes at a time when nursing teams are already short-staffed and overworked.

Norton has implemented a “Code Lavender” scheme (as an example, in the event of a patient death), which would prompt chaplain services or the hospital’s Employee Assistance Program to provide counseling to the traumatized employee.

Taylor of August Health mentioned their partnership with Healthy Nurse, Healthy Nation to help offset burnout and encourage team members to reconnect with the “joy of nursing.”

Non-Patient Impacts

As Carlisle-Spotts of Norton wisely noted, the surge in RSV cases “trickles down to every area of care,” putting additional strain on not only medical teams, but also those in food services, environmental services, social work, and chaplain services.

In addition to the RSV patients themselves, their parents need adequate care. Montefiore leans heavily on family learning specialists to provide emotional support to parents. Likewise, Norton’s child life specialists and chaplain services teams have taken on a prominent role in helping families coping with RSV diagnoses.

As part of prevention, all panelists mentioned programs in the community – including ambulatory providers and school nurses – to educate on best practices for curbing RSV transmission. These practices include the importance of isolating sick children from healthy siblings; the importance of proper handwashing; and, guidance on when it’s advisable for a child to stay home and recover, versus risking increased exposure in the hospital setting.

Learn More From Our Speakers
Visit to view our on-demand webinar series, including this presentation on RSV.

Tipton’s next webinar, Innovative Solutions to Staffing, will be held on December 1, 2022, from 12–1 p.m. EST.