It’s 6:45 a.m. Alexis Neill arrives for her twelve-hour shift at Unit 21 of Crawford Long Hospital of Emory University in Atlanta, a thirty-seven bed intermediate care unit for patients who are being prepped for or recovering from heart, lung, or vascular surgery. An intensive care unit is connected to Unit 21 by swinging doors at the end of two long hallways. Doctors and nurses rush back and forth between the cardiovascular unit and the ICU, lending an air of urgency.

Neill, twenty-four, is tall and slender, with a long ponytail that swings from shoulder to shoulder as she works. She’s dressed in pale green cotton scrubs with a black tank top underneath, white socks, white clogs. A stethoscope is draped around her neck.

She graduated from Emory’s School of Nursing in May of last year, then took a few months off to tour England and Ireland. After passing her nursing boards in August, Neill started working at Unit 21. She works forty hours over four days each week–two twelve-hour shifts and two eight-hour shifts–and makes $16.04 an hour ($33,400 a year) after a recent raise. “I worked here as an extern during my senior year of college, 7 a.m. to 3 p.m. Saturday and Sunday, so I was able to get day shift,” she says. “Of course, you make more an hour during evening and night shifts.”

The nursing shortage has hit Crawford Long, a 583-bed teaching hospital in midtown, as it has many hospitals across the country. To help care for more than twenty thousand inpatients and ninety thousand outpatients a year, the hospital has 822 nurses and 101 nursing techs. In the past two years, Crawford Long has hired 332 nurses and needs close to 80 more. Supervisors often try to fill the gaps with traveling nurses or agency nurses.

“We’ve seen a really big increase in that,” says Neill, who has been following articles about the shortage in the Atlanta Journal-Constitution. “But temporary nurses don’t know the doctors or routine orders for this unit, so we spend more of our time telling them what to do and showing them where things are.”

Neill has four patients today–a forty-five-year-old woman with a spontaneously collapsed lung, who is being prepared for surgery; a diabetic sixty-year-old man in the final stages of kidney disease, who has had artery bypass surgery in his legs to improve circulation; a sixty-six-year-old woman who is recovering from having a cancerous lung removed; and a fifty-four-year-old man with hepatitis C and latent tuberculosis, who is recovering from surgery to drain fluid from the sac around his heart.

“The patients rotate pretty quickly here,” Neill says. “I don’t have any of the same ones I had during my last shift. They try to give us a balance between very ill patients and ones who are stable.”

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