Space and staffing have become a major issue for health care providers in and around North Texas.
In its daily updates, Tuesday afternoon the Dallas-Fort Worth Hospital Council released a statement that Intensive Care Unit (ICU) beds in rural counties are at full capacity.
"Honestly it’s just staffing, having enough staff to take care of the patients we have has been the issue," said Lisa Hill, a spokesperson for Hunt Regional Healthcare.
Last Friday the Greenville health provider closed its Hunt Regional Emergency Medical Center in Commerce to bring a staff of 12 nurses to the main location.
Texas Health Presbyterian Hospital Rockwall made a similar move last Friday too and temporarily shut down its North ER Department satellite campus for the same reason. They've also added tents outside the hospital.
“Today things are looking a little bit better, our issue has been staffing," said Hill about the decision to temporarily close the other location.
They've also hired eight traveling nurses, who started on Tuesday which allowed them to open ten overflow beds in their post-anesthesia care area.
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"We have a 25-bed emergency room unit and we were holding an additional 23 patients, so it’s very helpful to get that nursing staff in so we can get some additional inpatient beds open," explained Hill.
Two medical tents now also sit outside the Greenville ER Department, which is now operational.
"What we did was, we were able to move patient registration, triage and waiting, out to the tents and that allowed us to set up a patient treatment area in our emergency room waiting room," said Hill. "We've got that space courted off into two separate areas. One is for COVID-19 positive patients and the other for non-COVID-19 patients."
Stephen Love, the president and CEO of the Dallas-Fort Worth Hospital Council said rural counties don't have ICU beds available and they're at 100% capacity.
"When you come into a pandemic situation like what we're in, they get swamped with patients already. The patients that are non-COVID-19, coupled with the COVID-19 patients, and they have limited facilities. They don't have large emergency rooms, they don't have really large ICU units, because normally they would need them," said Love.
Hill said they've had to transfer a couple of COVID-19 patients to San Antonio because they needed specialized treatment that wasn't available locally. As for non-coronavirus patients, they can treat most of them there but are in the same situation with little room to transfer to another hospital.
“Most hospitals are in the situation we’re in, they’re all full," said Hill.
As for staffing, on Monday Greg Abbott announced Texas would ask for help from medical personnel from out-of-state.
In a statement, the Texas Hospital Association said it applauded the news and stated, "This help could not come fast enough. Many hospitals have already idled non-essential services and are diverting patients to extend staffing capability. We look forward to a swift influx of out-of-state personnel, coordinated by the state through staffing agencies."
Love said since everybody in the country is fighting the coronavirus, it makes it more challenging to obtain staff.
"We were delighted to hear what the governor said yesterday, and we certainly hope the logistics can be worked out, so the state can help us get additional supplemental staff," said Love.
It's not just rural hospitals, but urban hospitals like Parkland in Dallas are experiencing shortages for several reasons. Everything from burnout, illness to higher-paying jobs.
Nurses have been opting to become traveling contractors which tends to pay more.
That has also made it challenging for hospitals this time around compared to the last surge.
"In the past, the state had three large traveling nurse contracts, and they were helping secure nurses, and other allied health professionals to supplement the existing staff we had and the state helped pay for a lot of that. Now what we're seeing is we'll work with different entities to get the revenue to pay for it. We just need the staffing," Explained Love.
He continued, "But what is so important is the state has such good purchasing power. When they go to these large agencies and say, 'We want to get staffing for the entire state.' It's much more of an economic boost for those firms than if it's just individual hospitals doing it."
Hill said they continue to hire people on the spot and hosted a job fair on Tuesday.
"We’re attempting to get as much nursing staff in as we can to be prepared for a continued growth in COVID patients," said Hunt.
Their goal is to continue bringing in additional contract nursing staff so they can reopen the Hunt Regional Emergency Medical Center in Commerce. They think it could take another 15 to 21 days.