St. Charles requests county, state help for 24 ICU nurses, but drop in patient counts offers hope

(Update: Saturday update; patient count declines; Military Dept. comment)

'We are really hoping that trend continues'

BEND, Ore. (KTVZ) – St. Charles Health System filed a request with Deschutes County and state officials for 24 help finding ICU nurses as it struggles to help a surge of patients, but there were some hopeful signs Saturday that the capacity crunch is easing.

On Friday, St. Charles spokeswoman Kayley Mendenhall said, "St. Charles has submitted a resource request for 24 ICU nurses. Technically, this request is submitted to Deschutes County, and the county escalates it to the state if they are unable to fill it.

On Saturday, Mendenhall told NewsChannel 21 that the request is pending, and added, "We have learned the state is tapping into the same pool of nurses we have already reached into for our emergent travelers.

"To put the number we requested into context, it is important to understand that at the time that we asked for 24 critical care nurses, we were anticipating the need to increase our critical care capacity into areas of the hospital where we don’t normally provide that level of care.

"At the time the order was placed, all of our ICU beds were full and we had eight COVID-positive patients on ventilators. We were hearing about 48-hour waits for ICU beds everywhere else in the state and were being forced to delay surgical cases that would need ICU care following the procedure," she said.

But Mendenhall added, "Hospital census is constantly fluctuating. Today, we are seeing a decrease in our ICU census of positive COVID patients and we are really hoping that trend continues. We are down to 33 COVID patients in the hospital, four of them in the ICU and three on ventilators."

That's down from Friday's count of 36 COVID patients, after several days where the total topped 40. Statewide COVID-19 hospitalizations and ICU numbers also have been declining in recent days.

Mendenhall explained Friday, "We have been doing periodic resource requests throughout the pandemic for testing supplies, gloves, etc. when we have been unable to secure these items ourselves. This resource request is for staffing (ICU nurses) and we have given the state the specifications for what we need. For instance, we have specified that they must have an Oregon RN license.

"The state is now working to try to fill this request using the resources at its disposal, such as coordinating with state agencies, statewide organizations including SERV-OR, the Oregon Disaster Medical team and more. Resources could be paid or volunteer, depending on their source, but all would be fully qualified and licensed. The state also determines how they fill a request and have not activated the National Guard at this time.

"These types of resource requests are submitted when we have tried every method at our disposal to meet this need ourselves and simply could not meet the need. Only then do we ask the county for assistance, and in turn they try to meet the need before escalating the request to the state.

"We have tried to fill our staffing needs with travelers, but have been unable to secure enough to meet the need since our hospitals have been running over capacity. We have also asked the state for assistance in expediting licenses for qualified out-of-state travelers, so we can continue to work on filling the request through our normal channels as much as possible."

The Oregon Nurses Association also on Friday provided an excerpt from a St. Charles email to caregivers, outlining the issues and steps taken:

CAPACITY
Here is the current census in each of our four hospitals, along with their respective capacities:

WHAT WE’VE DONE

Capacity

• Capped procedures requiring inpatient beds
• Opened Redmond Medical/Surgical 1, increasing capacity by 15 beds
• Converted Short Stay Unit 1 to inpatient beds
• Actively working with skilled nursing facilities, Home Health and other hospitals to place patients

Staffing

• Brought in 70 emergency RNs and have requested more
• Requested emergency staffing support from the National Guard
• St. Charles Medical Group has expanded hospitalist capacity via locums and other physician resources

Joel Hernandez, a St. Charles RN and ONA board member, said Friday, "While COVID-19 is causing hospital overcrowding, this situation didn’t develop overnight. Nurses at St. Charles were working short-staffed before the pandemic and have been struggling to get breaks since April.

"We need more support from St. Charles management in order to address staffing shortages before they become emergencies. That includes listening to frontline workers and investing in recruitment and retention, so we can continue providing the high-quality health care Oregon’s nurses are known for,” Hernandez said.

Meanwhile, amid space and staffing issues heading into the busy Memorial Day weekend with no room or people to spare, and the CEO issued a plea Friday for everyone, resident and visitor alike: Please be careful out there.

Here's a newsletter issued by St. Charles Health System President and CEO Joe Sluka, entitled, 'We Are Full and We Need Your Help':

"Our hospitals are full, thanks to a surge of COVID-19 patients and an influx of people who are sick because their care has been delayed for a variety of reasons over the past year. At the same time, history tells us to expect a significant spike in trauma patients during the upcoming holiday weekend.

"We have canceled surgeries, transferred patients to other hospitals and expanded patient care into spaces normally used for other things. We've brought in emergency nurses and requested more help from the state. And still, we are concerned that if someone comes in on Saturday with a severe injury or suffering from a heart attack, we may not have space to admit them to the hospital. All our beds are full. We are treating patients on gurneys in the hallways. Today, we have 15 people in the Emergency Department who are waiting for a bed to open up.

"There is a line out the door at your local hospital, and it's likely to get longer.

"We really need your help:

• If you haven't yet received the COVID-19 vaccine, you should continue to wear a mask and practice physical distancing, no matter what federal or state regulatory agencies have said. They are reacting to what's happening elsewhere. Here in Central Oregon, the pandemic is not over. COVID-19 is spreading rapidly and it's making younger people very sick. If you are unvaccinated, it is important for your health and safety that you distance and wear a mask. (Also, please get vaccinated. It's safe and effective. Of the 500+ COVID-19 patients at St. Charles since March 1, about 98% of them have not been fully vaccinated.)
• If you are vaccinated against COVID-19, please discuss with your unvaccinated friends and family the continued importance of masking and physical distancing, and encourage them to get vaccinated as soon as possible. At this point, you - a trusted friend or family member - is probably our best bet at convincing people to get the vaccine.
• Everyone: Be smart and be safe this weekend. Minimize risk. Avoid activities that could potentially cause injury. Skip the ATV ride or the ambitious hike and enjoy the holiday close to home. I assure you, now is not the time to get hurt and have to come visit us.
• If you have an emergency, of course, do not delay care. You should still come to St. Charles, and we will do everything we can to take care of you.

"On Thursday, Debbie Robinson, our chief nursing officer in Bend, said we are currently the busiest we've ever been in her time with the organization. She has worked for St. Charles for 26 years.

"Again, we need your help. We appreciate anything you can do to try to ease the pressure on the health system.

Sincerely,
Joe"