To some extent, that rationing is already happening. A patient still hospitalized here with COVID might have benefited from a machine, known as an ECMO machine, needed to keep his heart and lungs functioning. Operating that machine, though, requires at least one nurse, 24 hours a day, usually for two to three weeks. Typically, it would be a last-ditch effort for the most critical of patients. Even with that care, the prognosis for the middle-aged man would be poor. Without it, Baxter said, he will assuredly die.

“The reality is I can’t staff that,” Baxter said. “Do you give that optimal care to one patient or do you give great care to five?”…

Recently, a patient’s dying wish was to have their preschool-age child come and sit with them, to see them one last time. That typically wouldn’t be allowed, but an exception was made, with staffers at the hospital draping the child in oversized protective clothing, goggles and an N95 mask. Afterward, the nurse and doctor sobbed with the patient.

“The moral distress of working in health care is for many, many people extremely high right now,” said Allen.

Intensifying that, he said, are patients or their loved ones mistreating doctors and nurses. Threats have on occasion required a police response. Screaming, profanity-laden insults are a daily occurrence. One patient threw his own feces at a doctor. Some, even in the face of an intubation tube, question the need to be vaccinated or the effectiveness of the medicine being prescribed.