“We are in a crisis of standards of care”
HELENA – St. Peter’s Health has announced that they are in “crisis care” as their intensive care units reach full capacity.
Crisis standards of care arise when it is no longer possible to provide normal standards of care to all those in need. The need arises when health care resources are overwhelmed by a disaster or emergency.
In crisis care, hospital staff may be forced to assess patients on the basis of those who have a better chance of survival. Medicines can be rationed and patients can be sent home for a recovery that would normally be kept under observation if their condition worsened. St. Peter’s says the crisis standards are not a flipped switch situation, but a phased approach without formal levels and different departments can be at different levels depending on the number and severity of patients they are dealing with.
On Thursday, the regional hospital said its intensive care unit and advanced medical unit were at 100% capacity. Their mortuary is also full at the moment, and they have requested a refrigerated truck.
“We give our staff permission not to do everything. The hardest thing they will do in their careers will be not to give the care they are used to giving, but they just can’t. “said Chief Medical Officer Dr Shelly Harkins.
Harkins says the latest wave of COVID is different and worse than what was experienced in November 2020.
The hospital urges patients not to delay care and to go to emergency room or emergency care if they need it. Finding a medical problem early can help prevent it from becoming fatal.
“We’re always here to provide care to our community, and we do absolutely everything we can to keep all services open. Real emergencies will always be a priority,” Harkins explained.
While not all patients requiring intensive care are linked to COVID, the increase in the number of COVID patients requiring intensive care in conjunction with other critical patients has pushed the hospital to its limits.
Harkins adds that many Mountain West hospitals are in a similar situation. St. Peter’s has received calls from North Dakota, Idaho, Utah, Washington and Texas in recent weeks seeing that they have beds available.
“Our phones are ringing out of these places, on the other end of the line clinicians are desperate to find beds for very sick and dying patients on stretchers in their hallways and in the ERS. there are not enough beds in Mountain West to meet the needs, ”Harkins said.
This week alone, Missoula County tied its record for hospitalizations for COVID-19, said Bozeman Health on the verge of implementing a contingency plan due to COVID cases and the Billings Clinic is seeking to put implementing crisis care standards. All of Idaho is also now subject to crisis care standards.
St. Peter’s has requested assistance from the Montana National Guard in dealing with the crisis. They do not know if the request will be accepted.
In addition to the pandemic, St. Peter’s is facing a staffing shortage and the exhaustion of current employees. The health care organization says it has 200 open positions that are unfilled.
“Our staff are tired, they’re grieving, they’re frustrated,” Harkins said. “They are doing their best and they are doing a good job, but it’s a struggle to give your all and ultimately knowing that it’s still not enough.
Harkins added that the same staff have been verbally and sometimes physically assaulted on a daily basis.
The chief medical officer said she knows people are fed up with the medical community asking people to get vaccinated, but says it is the best and most readily available tool a person has to avoid to need treatment for COVID-19
“We cannot do it alone. We need the help of the communities,” Harkins pleaded. “The vaccine is safe and it works to keep you out of the emergency room and the hospital.”
St. Peter’s Health is also begging the community, vaccinated or not, to wear a mask indoors to limit the spread of the virus until the daily number of COVIDs has dramatically reduced.