Hospitals are buckling under the strain of nursing shortfalls and the spiraling cost of hiring replacements. For Watsonville Community Hospital ... those costs became too much to bear, and contributed to the facility's bankruptcy this month. The shortages are most acute at hospitals like Watsonville that rely on government funding to treat poorer patients. "This is like survival stakes," said Steven Shill, head of the health-care practice at advisory firm BDO USA. Winners are "whoever's highest on the food chain and who has the biggest checkbook." The staffing companies ... are "really, really, really gouging hospitals." St. John's, in a remote corner of Queens, treats some of the city's poorest and sickest patients. "This is the worst nursing shortage that I have witnessed in my career," Maureen May, a 30-year veteran of the pediatric ICU. The pain spreads beyond nurses. A report by human-resources firm Mercer this year estimated a shortfall of 3.2 million lower-wage workers, such as nursing assistants and home health aides, by 2026. Employers will also need to hire more than 1.1 million registered nurses in that period, Mercer said. Hospital labor costs rose 12.6% in October over the year-ago period. Two-thirds of nurses surveyed by the American Association of Critical-Care Nurses said their experiences during the pandemic have prompted them to consider leaving the field. And 21% of those polled in a study for the American Nurses Foundation said they planned to resign within the next six months.