New COVID surge stressing Montana health care systems

St. Peter's Health
Posted at 8:20 PM, Aug 30, 2021

HELENA — Frontline health care workers at St. Peter’s Health say the current COVID situation is like stepping back in time to January. Resources are being pushed to their limits and staff are burning out.

On Monday, Montana reported 736 new COVID-19 cases and 28 new hospitalizations since Friday, Aug. 27. Those numbers have not been out of the ordinary in recent weeks, following trends of increased cases and hospitalizations.

St. Peter’s Health Chief Medical Officer Dr. Shelly Harkins says she doesn’t think the public is really aware of just how dire of a situation is because outside the hospital it appears as if life is carrying on as if there isn’t a pandemic going on.

“We are surging again and our staff are suffering having to care for these very sick patients,” noted Harkins.

Harkins says it’s gotten to the point between COVID and regular critical care patients where they’ve had to room patients in the Emergency Department for days because there isn’t room on the medical floor or Intensive Care Unit (ICU).

“Over the last couple of months there have been days where we have not been able to admit another patient, where patients who needed an admission had to find another hospital— we had to find them another hospital to go to and sometimes that’s not even in the state of Montana,” explained Harkins.

St. Peter's isn't the only Montana medical facility suffering right now, with hospitals in the state regularly reaching out to other nearly facilities to see if space is available.

Burnout of staff is a big concern for St. Peter’s right now.

“It is exhausting,” said ER Registered Nurse Megan Carr. “Nobody has anticipated it going on this long and at times it can feel like a lot of the suffering is completely needless.”

The regional medical center is understaffed and there just isn’t help to go around right now.

“Because of the widespread nature of this current [COVID] wave that we’re in, there’s just not the availability of travel nurses to help relieve us here as there was previously,” explained ICU Registered Nurse Rick DePaso. “So it does mean people are picking up extra shifts and working extra hours to cover the needs we have.”

When the ICU fills up, nurses are pulled from other departments to help, which created an increased burden on those remaining nurses to cover the patients in their department.

At their height last week St. Peter’s had 14 COVID-19 patients needing hospital care. To put that in perspective, the hospital has 44 beds in total between their medical floor and ICU, meaning around 31 percent of the patient were just COVID-related for critical care.

It’s also not as if those beds are just sitting empty. St. Peter’s sees new patients from across the region every day that need treatment for conditions like heart failure, strokes, sepsis and other critical care needs.

Web Extra: ICU all COVID patients

“I’ve never seen it before to have commonality of patients in the ICU,” explained DePasso. “Currently in the ICU, as of when I walked off the floor a few minutes ago, all of our patients are COVID positive and all on ventilators, and unfortunately all unvaccinated.”

St. Peter’s ER, ICU and medical floor staff say that a patient’s vaccination status is what they worry about when they arrive for respiratory issues because they just can’t predict how bad they will get.

They’ve seen relatively few hospitalizations of vaccinated individuals, and those that do need care are in the hospital for a much shorter amount of time compared to those that haven’t gotten the shot.

“When you come to the emergency room or the ICU you trust us, you listen to us to guide your course to get better. We plead with you, listen to us now before you end up in the hospital because this is the time that really matters because it is just so hard to fight this illness once you get admitted and very ill,” said DePasso.

St. Peter’s staff say they’re dedicated fully to help anyone, vaccinated or not. Once a patient comes through their door they will do everything in their power to help. However, staff like Registered Respiratory Therapist Brian Jensen make sure those COVID patients are fully aware and prepared for the situation they face.

“You’re in this for weeks. It’s a fight. You are in this for days to weeks. And we’re here for you. We’re going to be with you every step of the way. You have to kick it before it kicks you,” he explained.

In critical COVID cases, the linings of the air sacs in a patient’s lungs are damaged which makes it difficult for them to get the oxygen they need. The lack of oxygen can make even simple tasks like standing up, an arduous process.

“They’ll be wiped out after getting a glass of water, they’re done,” explained Carr. “Then they’ll need to go lay down for another hour or two.”

It’s common for critical COVID patients to need to be put in the prone position for hours due to fluid that builds up in the lungs. Because of how weak the patient is for the lack of oxygen, staff are the ones that need to move them.

Web Extra: The process of proning explained

“It’s not an easy process because you’ve got IVs, they’re on a ventilator and it takes easily five strong people,” explained Registered Respiratory Therapist Brian Jensen.

Due to short staffing, the ICU has been depending on other departments like the ambulance crews to help and make sure the procedure is safe for patients.

To date, roughly 1 in 20 (5.0%) reported COVID cases in the state have resulted in a hospitalization. If you want to get vaccinated, contact your county health department, or click here.