Health
Increased COVID cases in Wisconsin can lead to ICU beds and staff shortages
Milwaukee — Wisconsin will run out of beds in the intensive care unit, and more importantly, nurses will staff them.
Only 187 of the state’s 1,469 intensive care unit beds were available when the state reported a record 5,200 positive cases on Tuesday. Of the ICU patients, 319 were being treated for COVID-19.
Bilmermus, Chief Medical Officer of the Marshfield Clinic Health System, said the number of COVID-19 patients treated could double in 2 to 6 weeks given the trajectory of new cases. ..
“There is nothing magical about this math,” Melms said. “All positives increase the likelihood or likelihood of having another patient in the hospital.”
Hospitals throughout the state are already tense to respond to the crisis, with exhausted staff taking extra shifts and working long hours. Some hospital systems are beginning to deploy temporary nurses to fill the shift in the coming weeks, including nurses from outside the state.
Less than 4 (approximately 3.5%) of 100 COVID-19 patients will eventually be admitted to the hospital. However, about 1 in 4 of those patients require ICU care.
This means that an estimated 36 of the more than 5,200 people who tested positive for the virus on Tuesday will enter the ICU, some of whom may be in the unit for several weeks.
It’s only one day.
Almost 28,000 people tested positive in 7 days. Therefore, 200 of them may need ICU care in the coming weeks. Also, there are no signs that the infection rate will decline.
On Wednesday, the state reported an additional 3,800 new cases and 45 deaths, with deaths reaching 1,897. The positive rate for the last 7 days was a record high of 27.2%.
In the state on Wednesday, there were records that 1,439 people, including 339 ICU patients, were hospitalized for the virus. This is about 20 more than the day before, an increase of 6% in one day.
“It’s real,” said Jeff Pothoff, physician and chief quality officer at UW Health. “We are now quite in the hot water in Wisconsin.”
UW Health, Marshfield Clinic, and other healthcare systems can add ICU beds. The challenge is staffing.
“Creating spaces isn’t too difficult,” said Pothof. “At this point, getting supplies is not that difficult. The biggest challenge is people.”
The ICU has an additional trained emergency nurse.
Ken Nelson, Chief Nursing Officer at HSHS St. Mary’s Hospital and HSHS St. Mary’s Hospital Medical Center in Green Bay, said:
Those hospitals are almost full.
“We are always planning for the next patient to go,” Nelson said.
Trends are also embarrassing.
“We are keenly aware of these numbers, which are released daily,” Nelson said.
Trying to maintain capacity
A field hospital or alternative care facility at State Fair Park in West Allis can provide care to COVID-19 patients who require a lower level of care. (There were 6 patients as of Wednesday.) It can release the hospital bed.
Hospitals have less flexible ICU beds. And most of those beds are needed for other seriously ill patients, such as those suffering from a heart attack or stroke.
“We must maintain the abilities of those individuals,” Melms said.
The Marshfield Clinic currently has an ICU bed available. The concern is the staff.
“That’s our limiting factor,” Melms said. “You give me endless staff, I’ll feel much better for the next 4 to 6 to 8 weeks.”
The Marshfield Clinic has moved nurses who can assist emergency nurses in the ICU. Aurora Healthcare did the same. And the medical system employs temporary workers, so-called travel nurses.
But those nurses are increasingly scarce.
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“Everyone is chasing them, and they are just as tired as everyone else,” Melms said.
ICU nurses usually work in 12-hour shifts three times a week. Most are picking up extra shifts. But it makes that sacrifice.
“The staff are completely exhausted,” said Pothof of UW Health. “They have dedicated everything in the last few months, but then this happens. You can only work in so many shifts.”
Nurses who provide care for COVID-19 patients should also wear masks and gowns during the shift.
“They are very tired,” Melms said. “They are emotionally exhausted. It’s not just physical. It’s emotional. We want them to do a lot.”
Change of staff, recruitment of temporary nurses
Large-scale medical systems such as Aurora Health Care have moved staff to another hospital.
“Currently, we have our own,” said Mary Beth Kingston, Chief Nursing Officer of Advocate Aurora Health, a healthcare system that operates 15 hospitals in the state, including Aurora. I am.
The health system is intended for 100 temporary or traveling nurses in November and December. There is also an emergency response plan to add ICU beds as needed.
“I’m not saying we’re not worried at all,” Kingston said. “We are very worried.”
So far, the healthcare system has not stopped performing selective procedures, but is reschedule some procedures when they can be safely performed for the patient.
In the spring, when the health system stopped such procedures, no one knew exactly what was going on, and so-called personal protective equipment-such as gowns and masks-was in short supply.
The healthcare system emphasizes that many patients need care, including those who are scheduled for cancer or heart surgery.
Nelson, Chief Nursing Officer at the Hospital Sisters Health System Hospital in Green Bay, said: “I’m frustrated.”
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Most of those patients do not need ICU care.
Some people argue that the healthcare system does not want to stop performing selective procedures because procedures are usually one of the most profitable services.
Marshfield’s Melmus challenges it.
“I speak to all healthcare professionals in the state. What we all do is put patient needs first, no matter what,” he said. “It’s all about providing care to patients who need it. The end of the story.”
The increase in cases was also frustrating for doctors, nurses and other staff.
“Our healthcare system cannot be an unlimited backstop for COVID,” said Eric Borgerding, CEO of the Wisconsin Hospital Association. “We have to start taking this more seriously and consistently seriously. This is the real thing.”
This trend poses another challenge. A high infection rate means that hospital employees are at high risk of being exposed to the virus.
The Marshfield Clinic has an estimated 10% of its 12,000 employees because it is infected with COVID-19 or exposed to people who need to be quarantined, Melmus said.
The risk is increasing day by day.
“I wake up and know that there is light at the end of the tunnel, so I want to start seeing the number of positive cases where the condition is starting to decline,” Melms said. “After that, at some point, we will see a decrease in the census rather than an increase in the census.
“There is no light at the end of the tunnel until you see it.”
Contributions: John Forber and Sofia Carson, Milwaukee Journal Sentinel.
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