Rural Hospitals Continue to Experience Demand, Fatigue and Staffing Shortages

Rural healthcare providers are also calling for help as the COVID-19 surge impacts other services

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No matter the size of hospital, health care systems across Texas continue to feel the stress of increased COVID-19 patients. Rural hospitals, which are typically already operating at a minimum, are no exception.

"I’m actually worried that we have rural hospitals in Texas that can buckle under the pressure because their nurses are wiped out, their doctors are wiped out. Their communities aren’t nearly where they need to be in terms of vaccination, and they’re just getting run over,” said John Henderson, president and CEO of the Texas Organization of Rural & Community Hospitals.

In Mineral Wells the head of Palo Pinto General Hospital said they're seeing firsthand how the latest surge is impacting their operations.

"We've been very, very busy. From our ER, to our ICU, to our COVID units in the hospital. The hospital has basically been full for the last couple of weeks," said Ross Korkmas CEO of Palo Pinto General Hospital. "Staffing has been very thin and that's something you're seeing across the state for sure, not just metro hospitals but rural hospitals are facing this as well."

He said they've stopped elective surgeries to move nurses to their emergency department to help with the number of patients they're receiving.

Korkmas said in their hospital they only have eight Intensive Care Unit beds, six of which are currently being used by COVID-19 patients.

In their medical surgery unit, treating 25 to 30 patients is considered pushing it. Monday morning the hospital had about 37 patients in their census.

What we would call our average daily census is about 25 patients, so when you get up into the 40s and low 50s of patients, you've effectively doubled the number of patients that you care for on a regular basis. So you've got to find people to help come in so that we can provide that level of care that people expect," he explained.

The hospital is a level four trauma facility. The Texas Department of State Health Services defines this as a basic facility that provides resuscitation, stabilization and assessment of injury victims along with other forms of care.

Many rural hospitals rely on bigger hospitals to transfer patients needing more invasive treatments, but because of the rise in patients across the board, that's been an issue.

"We don't do open-heart surgery, we don't do heart casts, we don't do invasive stroke care, so we have to send patients to our metro hospitals and as they're busy dealing with COVID-19 patients, there are other patients that's going to be a struggle to get transferred to those facilities," he said.

"As those large hospitals are filled up, it's becoming increasingly difficult to get patients transferred. So we find ourselves sometimes holding patients for several hours. Sometimes admitting patients here that we would not normally admit just attempting to provide them with the appropriate care the best care we can until we can get a bed available," explained Dr. John Jones, medical director for emergency services at Palo Pinto General Hospital.

Jones said the combination of all of this is leaving his staff tired.

"Last summer we had our big surge, so to speak, and we worked hard. We worked really hard, taking care of patients in large numbers of patients that frankly was not routine for us at that time," said Jones. "Now to see this surge it's, it's honestly deflating. At times and to see the rate of rise, be so significant in comparison to the first surge is demoralizing at times.”

He said most people they're currently treating for COVID-19 are not vaccinated.

"Putting aside political stances, or what side of the fence you stand on, I think the science bears out that vaccinations do help and I would certainly recommend that our communities get vaccinated and push to get vaccinated at this time," said Jones.

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