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Staffing could be an issue for hospitals if coronavirus surge hits Treasure Valley

On Friday, doctors from both Saint Alphonsus and St. Luke's told KTVB they have capacity, but a surge could be coming in the next two to three weeks.

BOISE, Idaho — Hospital capacity is a big reason medical professionals are urging people to take protective measures against COVID-19.

Right now, the two largest hospitals, Saint Alphonsus and St. Luke’s, in the Treasure Valley said they're managing capacity at this time.

When looking at overall hospital capacity, doctors said it’s not only about the number of available beds, it’s also about their staffing levels and how much medicine and PPE they have. 

If we look at the hospital capacity picture for Friday, June 24, hospitals are managing it.

“In terms of our overall capacity, we are fine. We’ve got fully staffed beds,” Saint Alphonsus Chief Clinical Officer Dr. Steven Nemerson said.

While the hospital does have capacity, Nemerson told KTVB there are already impacts on the level of care the hospital can provide due to the number of patients with COVID-19 in the hospital.

“Right now, if someone is diagnosed with a cancer and has a tumor and that tumor needs to come out, under normal circumstances we would've taken it out the very next day,” he said. “Now it's going to have to wait a couple of days, maybe longer.”

He estimates COVID-19 patients make up 20% of all inpatient beds.

“The COVID train is here now. The numbers are profound,” he said. “We expect in coming weeks is that percentage of COVID patients will continue to rise and in order to accommodate those patients, we will have to delay some of the more urgent and medically necessary procedures in order to accommodate those needs as well. That frankly is the tragedy of the pandemic at the moment.”

Another thing that complicates things is the amount of healthcare workers out sick, or showing symptoms of COVID-19, or quarantined after being exposed.

“The bigger issue isn't the physical beds, it’s our ability to maintain the appropriate level of staff to meet the patient needs,” Nemerson said. “What we need to focus on is our ability to continue to accommodate patient need under what we would call normal operations, and disappointingly we’re already compromising on that.”

Over at St. Luke’s, Dr Barton Hill told KTVB the hospital is seeing a similar situation play out.

“Right now, we're in that range but we're seeing it go up, especially in the last two to three weeks,” he said.

So, the hospital is taking steps to manage their capacity. One of the first steps is to maximize their current beds.

“We have started to not schedule new procedures over the next two to three weeks because we need to be able to have capacity to take care of the usual health care conditions,” Hill said.

Ultimately, it may come down to more than just beds and equipment may not be the big issue.

“We think it’s ultimately going to be staffing and it’s not just any staff, certain staff have a skillset that you just can't replace,” Hill said. “You can’t take a critical care nurse that is not available and put in any other nurse in that role, that need to have the level of experience and that skillset in order to provide the expected level of care that is necessary.”

St. Luke’s is also working around their employees not coming to work due to a myriad of reasons. They could be sick themselves, showing symptoms, be exposed, or must care for someone that is sick.

“On any given day, we can have 40 to 80 or more staff who are not available to work,” Hill said.

Some Idaho healthcare workers went to New York City earlier in the pandemic to help care for patients there. Both Nemerson and Hill said they aren't requesting nurses come in from out of state right now, but St. Luke's is taking other measures.

“It is looking like it is getting worse, and so we're preparing for additional capabilities, capacity and resources,” Hill said. “We are taking steps as an organization to recruit temporary staff, especially with a skillset of critical care.”

They hope to have them in place in the next week to three weeks to be ready for a possible surge. Hill thinks a surge is possible simply because of what he’s been seeing both in and out of the hospital.

“We’ve been seeing the volumes increase in the last two to three weeks and we’re not seeing necessarily the behaviors in our communities of wearing masks, social distancing, not gathering in large groups, really diligent hand hygiene and if those behaviors don’t change, why would we expect we’re suddenly going to see decreases coming to the hospital,” he said.

In the last two weeks, the ICU capacity in the Nampa St. Luke’s was full a number of days. The hospital then moved patients over to their Boise location to try and help.

However, staffing remains a critical component for hospitals right now. Because a bed doesn’t do much good if there aren’t healthcare workers to care for the patient in the bed.

“We’ve been consistently seeing over the last two to three weeks that our ICU census is about 20 percent higher than it was same time a year ago,” Hill said. “Our hospital census is about 10 percent higher than it was a year ago.”

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