On August 31, Memorial Hospital of Sweetwater Countyannounced they are canceling all elective surgeries. This comes right after the Rock Springs hospital had a completely full ICUover the weekend. Wyoming Public Radio's Kamila Kudelska spoke with the Director of Emergency Services and Incident Commander, Kim White, to understand why elective surgeries had to be canceled.
Kim White: We are using the nurses that would be doing elective surgeries to take care of the critical COVID patients that we have right now. We are able to do emergent and medically necessary surgery. So we haven't cut down all surgeries, just the elective ones that a patient can still be safe and still maintain their health until a later date when we're able to get those surgeries done.
Kamila Kudelska: Okay. And as I understand the Memorial Hospital is experiencing a staff shortage. Is this part of the problem?
KW: We have had a few nurses leave on our inpatient site. So that has definitely caused a decrease in bed availability. We don't have the ability to transfer people out very often. Every once in a while we get this miracle minute where we are able to find a bed in another facility for our sickest patients. But the biggest thing impacting us right now is that we have 11 COVID patients admitted to our hospital and eight of those are in critical care. And so those patients require a smaller patient-to-nurse ratio and they require more hands-on deck to take care of them, and so that's what our surgery nurses are doing right now is they are helping out in our COVID unit/ICU and also helping on the medical floor. And then also the ER has been so inundated with COVID, that they're helping down there as well. So they are taking care of them, our critical patients, right now, and that's what's taken away their ability, our ability, to help with elective surgeries.
KK: Do you think it's the staff shortage or influx of COVID patients or both, that brought you to where you are now?
KW: It's a little bit of both. But right now, this past week, a week and a half, it's definitely more the increase in COVID patients. These patients are on high amounts of oxygen, they're on BiPAP machines, which help them breathe in there. You know, some of them are having to be intubated. And so it requires more time, more treatments, and things like that. And so when you have this amount of patients, we haven't had this amount of COVID patients admitted to our facility throughout the entire length, at any one time during the pandemic. And so, unfortunately, we can't send these patients to higher levels of care, because they're full as well. We have been able to get a few, like I said, when we have that miracle moment when a bed opens up when we call but that's few and far between. So the fact that we have higher acuity patients, we have more patients than we usually have is what's hurting us the most right now. Well not hurting us necessarily, but making it impossible to be able to do the elective surgeries.
When people come into the ER, we ask them if they're up to date on vaccinations. So it's just a routine health question that we ask. It's not just because of COVID. It's simply because we want to make sure if you've got a cut finger, you're up to date on your tetanus shot. You're coming in with the flu, if you had flu-like symptoms, if you had your flu shot, you know, those are all typical things that we ask. And so it's no different now with COVID than it was prior to COVID.Kim White, Director of Emergency Services and Incident Commander
KK: As I understand the ICU was full this past weekend. Is it still full? Or are there beds available already?
KW: We actually have today (9/1/21) two beds available in our ICU. We do have that. So you know, the big thing is not only is it COVID patients, but we have other patients with our patients with other diagnoses that are needing those ICU beds as well.
KK: And as the incident commander, what's the plan if the ICU is full and you can't send patients to other hospitals?
KW: So that's the other reason why elective surgeries had been postponed. We would actually start moving patients down or admitting patients into our same-day surgery area, which has the ability, it has the monitors that have the oxygen and it has everything that we need to be able to take care of patients down there as well.
KK: Are the majority of COVID patients unvaccinated?
KW: Yes, the majority of them are unvaccinated. And can I add to that real quick? I've personally been asked if that's an invasion of privacy to know whether or not someone is vaccinated. And my answer to that is even prior to COVID, when people come into the ER, we ask them if they're up to date on vaccinations. So it's just a routine health question that we ask. It's not just because of COVID. It's simply because we want to make sure if you've got a cut finger, you're up to date on your tetanus shot. You're coming in with the flu, if you had flu-like symptoms, if you had your flu shot, you know, those are all typical things that we ask. And so it's no different now with COVID than it was prior to COVID.
KK: And how would this situation have to change so that elective surgeries can start again?
KW: So with the plan that we have in place, we start looking at elective surgeries based on the acuity and the number of patients that we have. If we were able to get back down to a better number of patients, both COVID and non-COVID patients, requiring ICU or requiring beds upstairs, then we would be able to. I don't want to say a definite number just because it is based on acuity and the treatment that the patients require. But typically, I would say around five or six patients in the ICU would be more manageable for us to be able to open up. This is not a decision that we want to make. We have our own staff members that are on that list of elective surgeries that are unable to take place at this time. Not that they take more importance over anyone else but it is hard when you see someone on a daily basis and you're constantly having to tell them, you know, not today, not today. We want to get elective surgeries open back up as soon as possible. That's our first priority. We evaluate it every day. As soon as we can, we'll get it back open and I hope people will understand that. We're just having to prioritize who has the more critical need at this time.
