Steep revenue drops have forced small and rural hospitals to lay off staff.

As the battle against COVID-19 ramps up across the nation, health care professionals at small and rural hospitals are getting furloughed, reassigned and told their employment contracts are canceled.

Leanne Helmerich is one of 600 staff members furloughed at Hillcrest Medical System in Tulsa County, Oklahoma. She’s out of a job after the hospital announced staff reductions Monday, hoping to consolidate resources during the coronavirus pandemic. She won’t be back until the “need arises.”

“It’s a big pot of emotions,” Helmerich said. “But mostly I’m worried about how I’m going to pay the bills.”

Abby Cachero works as a contract nurse at Integris Baptist Medical Center in Oklahoma City. After weeks of canceled shifts and reduced hours, her hospital said it would cease virtually all operations outside the emergency room, leaving Cachero in the dark on her employment status.

“I don’t even know if I still have a contract with them,” Cachero said. “I’m talking with my recruiter asking if I should be prepared to leave the state for work.”

The latest jobs report from Altarum, a nonprofit research firm for government health insurers, found the health care sector lost 43,000 jobs in March — the largest decline in three decades — amidst the ongoing pandemic.

Even health care workers trained to fight COVID-19 are having trouble finding steady employment in some regions. Ben McGuire worked as a contract nurse at an intensive care unit in an Oklahoma hospital for two years. He was notified his contract was terminated while on the way in for his regularly scheduled shift.

“I was putting on my scrubs and got a message that I was canceled,” McGuire said. “It took me by surprise because we were super busy in the ICU trying to save lives.”

Reports of similar stories have surfaced in rural communities across America’s heartland in particular. Mountain Health Network has furloughed the majority of their 6,000 employees at hospitals throughout West Virginia. The Cookeville Regional Medical Center in Tennessee sent home 400 staff members last week and will cut hours of other employees. The Medical University of South Carolina laid off 900 workers and Ohio’s largest health system has temporarily laid off 700 nonmedical workers.

Hospitals across Oklahoma have followed the national trend of canceling all elective surgeries, hoping to be ready in case COVID-19 cases spike in their region. And while it’s essential to be prepared for what may come, it’s also putting a massive dent in the hospitals bottom line.

“Let’s be clear, elective surgeries are the lifeblood of many hospitals, if not all hospitals,” said Mary Dale Peterson, president of the American Society of Anesthesiologists. “They account for 50 to 60% of profits for most.”

Hillcrest Medical System CEO Kevin Gross said surgeries are down 75% systemwide, which creates a massive revenue problem, resulting in layoffs as the hospital “seeks to balance our resources against the economic impact we are seeing.”

Meanwhile hospitals in New York and New Jersey are scrambling to hire health care workers as the coronavirus overwhelms their ER wards — offering nurses as much as $6,000 a week for their services. New York City Mayor Bill de Blasio has pleaded for doctors and nurses to come to the city to help. The Department of Veterans Affairs is struggling to find additional health care workers for its government-run hospitals in the San Francisco Bay Area and Chicago.

But some medical professionals feel they are being discouraged from going where they’re needed most.

Colby Pacheco currently works as a contract nurse at an Oklahoma hospital, but feels his role might be on the chopping block if furloughs continue. He’s considering an out-of-state move temporarily to aid overwhelmed health care colleagues in hotspot zones. The idea hasn’t been well received in his community.

“I’ve had Facebook friends post that we’re cowards, sellouts and leaving Oklahoma vulnerable for when COVID-19 hits,” Pacheco said. “When you explain there is no work here, people say we need to buckle down and it’s our civic duty to stay.”

Above all, Pacheco hopes hospitals and the general public don’t lose sight of what’s most important: saving lives.

“It’s a weird position to be in as a nurse, not knowing if you’ll have a job during a pandemic,” Pacheco said. “I just hope big business doesn’t get in the way of nurses doing their jobs and helping people.”