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Pandemic makes life tough for area hospitals

Pandemic makes life tough for area hospitals

Influx of patients taxing medical teams


COVID-19 has area hospital administrators worried about the toll its taking on employees and their ability to take care of patients.

In a news release Wednesday, Memorial Hospital in Aurora indicated it “has reached critical staffing levels and bed availability due to the surge in COVID-19 related illness.” As a result, the hospital has temporarily suspended elective surgeries.

In a COVID-19 update early last week, Valley County Health System in Ord said it’s “very concerned what the future may bring unless we take action very soon.”

The effects of the pandemic “are putting both our health care workers and our patients at risk,” according to Valley County Health System.

“Our hospital staff is challenged with taking care of very sick COVID patients as well as other illnesses and accidents that come through our doors,” the Ord hospital reports. “The COVID-19 surge is upon us. We have a loyal and dedicated team of men and women working here, but they’re feeling the strain. Working in full personal protective equipment is not easy. However, it is necessary in order to care for our patients.”

In a letter to the editor, Patrick Avila, president and CEO of Merrick Medical Center in Central City, wrote that “our hospital staff is currently being stretched and pushed to the limit.”

It’s taking longer to transfer patients to larger hospitals “because there are a limited number of beds available throughout the state,” said Nancy Glaubke, CEO of Valley County Health System.

Hospitals are “getting inundated with more and more COVID patients,” Avila said.

Normally, Merrick Medical Center has the ability to transfer sicker patients to Bryan Health in Lincoln and other larger facilities, such as the two in Grand Island, for a higher level of care.

Because of the coronavirus, the patients are staying “in our facility a little bit longer as we wait for a bed to open up,” Avila said.

The Merrick Medical Center employees are capable of handling those patients during the wait, but “it burns through our staff fairly quickly because these patients require more one-on-one care” from nurses, he said.

It’s a staffing issue more than a space issue, Avila said. Merrick Medical Center has “fantastic doctors” and “a fantastic staff,” but “the staff is starting to reach a stress point, I would say.”

Supporting the effort and each other, nurses sometimes pick up extra shifts or work extra days, which leads to fatigue over time.

The situation is making life difficult not just for nurses.

“Our lab techs are working 12- to 16-hour days because we’re seeing a higher number of patients needing to get tested,” Avila said.

Many are tested at the busy drive-thru at Central City Medical Clinic. Each day, staff members test 35 to 40 people who are experiencing respiratory issues and COVID-like symptoms.

Initially a canopy drive-thru, it has been replaced by a metal building. The structure keeps providers and people being tested out of the elements, Avila said.

Merrick Medical Center, Memorial Hospital and Valley County Health System all are critical access hospitals.

Diane Keller, CEO of Memorial Hospital, said facilities such as those move patients to larger hospitals that have “additional services that we can’t provide.”

The Aurora hospital also halted elective surgeries in late March, following public health guidelines. This time, elective surgeries were stopped for a different reason.

Keller said the number of COVID-19 patients has made the hospital “very busy.”

Critical access hospitals face delays in transferring recovering patients as well as people who are suffering.

The Aurora hospital is having issues getting recovering patients “to a lower level of care, like to a nursing home or assisted living,” she said.

Many of those facilities have their own COVID-19 patients who they’re caring for. They have strict criteria about their own patients “and they have staffing issues as well,” Keller said. “So we’re having some difficulty moving people on both ends.”

In his letter to the editor, Avila wrote that it’s necessary to protect the health of hospital employees “so that they can continue to care for our patients. I’m also very concerned about our availability to manage patients, whether they have contracted COVID-19 or not. We have a limited supply of beds and resources and if the numbers don’t slow down, we’ll be faced with extremely difficult decisions in terms of who gets needed care and who may have to wait.”

Hospitals call a COVID-19 hotline, which helps them determine which facilities have the capacity to help. Getting an answer sometimes takes a couple of hours.

It’s a good process, Glaubke said.

“Otherwise we’d be calling all of the hospitals ourselves, and so would every other critical access hospital around here,” she said.

But the process does take some extra time.

“The hospitals around here have been very, very good to us,” Glaubke said. Valley County Health has “a great relationship” with the hospitals in Grand Island and Kearney.

The bigger issue is “that most people are not taking the situation seriously enough,” she said. “They think that because the hospital has always been there to take care of them, the hospital and health care services will always be there for them.

“I don’t think that they realize that if we lose any more nurses or lab personnel — not just here in Ord but other hospitals throughout the state — that there might be a case where the hospital is not available for them. And that would be tragic,” Glaubke said.

Valley County Health is fortunate in that only a few nurses are unable to work. But it’s “very precarious,” she said.

A nursing shortage existed even before the pandemic, and now with the coronavirus, “it puts an additional strain on our staffing, not just nursing but lab and everyone,” Glaubke said.

Failing to take the virus seriously is not exclusive to the Ord area. She said that’s true of the Dakotas and “the whole Midwest.”

In the middle of the country, people became complacent, thinking COVID-19 might be limited to the East and West coasts.

“We were feeling a little smug, like it’s not going to come here,” Glaubke said. “We’ve got wide open spaces and we felt like this wasn’t going to impact us.

“But unfortunately, it certainly has,” she said.

“There are a lot of people who absolutely refuse to wear masks. They don’t believe in it,” Glaubke said. “That certainly is their right, but it certainly does create a challenge then for our health care workers who have to deal with the aftermath of that.”

Avila doesn’t expect COVID-19 to go away soon. He’s nervous about family gatherings during the holidays. When people gather together it’s hard to avoid the three C’s — crowded places, close contacts and confined spaces.

“So we’re worried about what the next couple months look like. I don’t see any immediate end in sight,” he said, adding that he’s worried about the fatigue level of his staff members.

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