Providence St. Peter Emergency Department staff respond to the largest increase in COVID cases since the start of the pandemic, as they face hallways full of patients waiting and some waiting in ambulances in outside.
“The sharpness we see is far beyond what we’ve seen before,” Dr. Penelope Goode told The Olympian. “Now, with the recent increase in COVID cases due to the delta variant, it’s just unprecedented – the volumes, the wait times and what we need to do to try and treat these patients safely. security. “
Goode works in the St. Peter’s Emergency Department. She told The Olympian that the number of patients passing through her department has increased in recent weeks as Thurston County has seen the fifth wave of COVID-19 push transmission rates and the number of cases to record levels. .
As the delta variant crosses a county population that is only 50.6% fully vaccinated, Saint-Pierre has been inundated with increasingly sick patients, senior nurse Arthur Andrews said.
Meanwhile, a similar situation has occurred in hospitals in western Washington and across the country, making transfers increasingly difficult, said Providence spokeswoman Angela Maki.
“We have hospitals calling us from surrounding states – Montana, Alaska, Northern California, Oregon – to try and get us to pick up their patients on any given day,” Maki said. “It’s not a unique situation.”
The impact of COVID-19
Not all emergency room patients have COVID-19, but given the variety of symptoms that could be attributed to the disease, Andrews said they need to treat many patients as if they have COVID. -19 until proven otherwise.
Most patients, especially those who require intensive care, are not vaccinated against COVID-19, Goode said. She urges all her patients to get vaccinated if they haven’t, saying the vaccines are safe and effective in preventing serious illness and hospitalization.
“When I paint the picture of the reality that is out there right now… it’s like I’m telling them whole new information,” Goode said. “Their eyes widen, it’s like they’ve never heard it before.”
Many are alarmed and say they will reconsider their decision, Goode said. Most people who are seriously ill with COVID-19 tend to regret.
“Super sick people ask, ‘Can I have it now? Can I get the vaccine now? ‘ ”Goode said. “They are terrified and there is sure regret that they missed the opportunity to receive this life-saving vaccine.”
People’s resistance to the vaccine caused many staff to experience what Goode called “compassion fatigue.” While they are doing their best to treat patients, she said the ongoing pandemic can take its toll.
“The nurses, technicians and doctors and anyone who has worked like a dog for 18 months are exhausted,” Goode said. “It’s such an affront to these people that here is this treatment, this vaccine, that would make all the difference in the world and people are refusing to get it.”
While there can be side effects to getting the vaccine, the benefits far outweigh the risk, and the ramifications of not getting the vaccine are huge, she said.
“We beg you,” Goode said. “We beg you to get vaccinated because it is the solution to this problem.”
St. Peter’s emergency department has around 40 beds, but lately they’ve been forced to use around 20 extra beds in the hallways, Andrews said.
While the situation is tense, Andrews says there are contingency plans to use surge areas as needed.
“We are opening up these surge areas as needed, to help accommodate these high numbers that we are encountering to try and give us a chance to fight in this wave that we have passed,” Andrews said.
He said more than 200 patients go to the emergency room on average per day – about 25 more than before the pandemic.
However, Goode said the department exceeds the department’s 100 patients – in waiting rooms, triage area, hallway beds and regular rooms – a few times a week.
“I’ll have a whole shift where two-thirds of the patients I see, I see in a hallway,” Goode said. “You just adapt and you sort of adapt to the situation to take good care of these people, but the circumstances are not trivial. “
Many inpatients occupy beds in the emergency department because there is not enough space in other areas of the hospital. Goode said it caused staff a so-called moral injury.
“Everyone knows what’s going to happen, knows how we want to take care of trauma patients, stroke patients, COVID patients and all that, but we just don’t have the space to do it ”Goode said.
About 95% of Saint-Pierre’s conventional ventilators are used, Maki said. However, they have more emergency and crisis ventilators that they can use as needed.
“We have a lot of built-in diapers so that we can take care of our community with ventilators, so we’re going to be able to have the ventilators if they are needed,” Maki said.
As a precaution, the hospital has requested more ventilators from the state, she said, but it is still unclear whether they will receive them soon.
Additionally, Providence can transfer ventilators between hospitals as needed, said Providence spokesperson Chris Thomas.
“St. Peter is the hub, the largest hospital in the five-county service area,” Thomas said. “Thus, the sickest COVID-19 patients are often transferred to Saint-Pierre. That’s why a lot of ventilators would be used there compared to other small hospitals that we can access ventilators. “
Adequate staffing is another concern that has plagued hospitals in recent weeks. Although Andrews acknowledged this to be a problem, he said cases of people leaving the emergency department were “few and far between”.
Despite the hurdles, Goode and Andrews said staff continued to address these challenges to meet patient needs.
“Frankly, this is the toughest group of individuals I have ever had the privilege of working with,” Andrews said. “They inspire me to come to work every day and do my best, with the work they do for the community every day.”
Transportation delays with ambulances
Patients arriving by ambulance sometimes have to wait with emergency medical services teams before entering the hospital. Andrews said this happens when there aren’t enough beds to transfer patients or they can’t wait safely in the triage area.
“Someone could be in a car accident and maybe they can’t sit in a chair or can’t get to the yard area,” Andrews said. “In these cases, we have to wait for a bed to open before we can remove them from EMS transport.”
Kurt Hardin, Thurston County’s Medic One system director, told The Olympian that transportation delays sometimes exceed an hour, but new mitigation measures have reduced wait times slightly over the past month.
The Medic One system integrates 12 independent fire departments, two ambulance companies, hundreds of EMS providers and two hospitals.
He said Medic One prepared a peak capacity transport unit and arranged for a team of emergency medical technicians to continue caring for a patient while the ambulance returns to the field. .
However, these metrics are not available every day due to personnel issues. At present, Hardin said they are moving staff and looking to hire temporary paramedics to ensure these measures are available seven days a week.
Although there are transportation delays, Hardin stressed that there was no delay in responding, which means people can still reliably call for help.
“If you need EMS, call 911,” Hardin said. ” We answer. It’s just that we are currently prioritizing transport to those who are sickest …
“I don’t want people to think you have to wait an hour or two for someone to show up.”