Two out of five Americans live where COVID-19 is burdening the ICU in the hospital

The intensive care unit is the ultimate defense against the most ill patients on the verge of choking or facing organ failure. Nurses working in the most stressful ICUs, changing IV bags and monitoring patients with respiratory organs are exhausted.

“You can’t push great people forever. Right? That’s impossible,” said Dr. Mark Boom, CEO of Houston Methodist. He is one of many hospital leaders hoping that the number of severely ill COVID-19 patients has begun to peak. Worryingly, Texas has an average of 20,000 new cases per day, the third highest number of deaths in the country, with more than 13,000 people hospitalized for COVID-19-related symptoms.

Hospitalizations are still high in the west and south, with more than 80,000 COVID-19 inpatients currently in these areas, according to data from the COVID tracking project to Thursday. Reassuringly, hospitalizations appear to be flat or declining in all regions. It is unclear whether a more contagious version of the virus will emerge and will be caught in the deployment of the vaccine and continue to be mitigated.

In New Mexico, a rapidly growing hospital system has invited 300 temporary nurses from outside the state to cost millions of dollars to deal with the overflow of remodeled operating rooms and ICU patients treated in the operating rooms. did.

“That was horrifying,” said Dr. Jason Mitchell, Chief Healthcare Officer for Presbyterian Health Services in Albuquerque. He comforted that the hospital never activated plans to allocate life-saving care. It would have had to rank patients by numerical score based on who the triage team was least likely to survive.

“I’m relieved that I didn’t actually have to do that,” Mitchell said. “I’m scared because I’m scared.”

In Los Angeles, the Cedars-Sinai Medical Center was short of take-out oxygen cylinders. That is, some patients who were unable to return home occupied the necessary beds and were kept longer. But the biggest problem is competing with other hospitals for travel nurses.

“Initially, when the COVID surge hit parts of the country at once, travel nurses were able to go to more seriously affected areas. The hospital’s chief operating officer, Jeff Smith. “Now almost the whole country is skyrocketing at the same time,” he said, and hospitals are paying twice and three times the amount they normally pay for temporary nurses.

The Houston Methodist Hospital recently paid a $ 8,000 retention bonus to prevent staff nurses from signing up for agencies that send them to other hotspots. Nurses’ payments while traveling can reach $ 6,000 per week. This can benefit nurses, but it can look like poaching to hospital executives watching nurses leave.

“There are many of these institutions that are charging absolutely ridiculous amounts to accept ICU nurses,” Boom said. “They go to California in the midst of a surge, where they poach some ICU nurses and send them to Texas, where they charge an exorbitant amount to fill the Texas gap. Many are created because they were done by a Texas nurse. Return to Florida or California. “

Space is another matter. The Augusta University Medical Center in Augusta, Georgia treats adult ICU patients under the age of 30 in a children’s hospital. Currently, there are ICU patients in the recovery room, and if things get worse, other areas such as the operating room and endoscopy center will be the next critical care unit.

To prevent local hospitals from sending more patients to Augusta, they use telemedicine to allow local hospitals to manage them for as long as possible.

“This is a model that I believe will not only survive the pandemic, but will prosper after the pandemic,” said Dr. Phillip Coule, Chief Medical Officer at Augusta Hospital.

The hospital is urging the community to wear masks and limit meetings.

Dr. William Smith, Chief Medical Officer at the Cullman Community Medical Center in Kullman, Alabama, said: “Unfortunately, there wasn’t much respect for the disease. He thinks it’s changing now as more people know the dead personally.

“It took a lot of people,” he said of the virus, adding that the death toll (144 in 6 months in 84,000 counties) “opened his eyes to the randomness of this.”

The ICU at Alabama Hospital flooded for six weeks, with 16 virus patients on ventilators in a hospital that had only 10 respiratory organs a year ago. “You can see stress in people’s faces and their body language. It’s hard for people to carry around,” Smith said.

“Only staff fatigue can affect the quality of care. I was encouraged to keep the quality of care high,” Smith said. “I feel like I’m in a very volatile situation where errors can occur, but thankfully we’ve always been able to keep track of things.”

Hospitals say they support high standards of patient care, but experts say surges jeopardize many normal medical practices. Overwhelmed hospitals can be forced to mobilize ad hoc ICUs and assign personnel with no life-saving experience. While using a ventilator, you may run out of sedatives, antibiotics, IVs, or other supplies that you rely on to keep your patients calm and comfortable.

“It’s a really mind-boggling mental burden. Kiersten Henry, a nurse at the MedStar Montgomery Medical Center in Olney, Maryland, and a board member of the American Association of Emergency Nurses, said: I will.

In Oklahoma City, Dr. Cameron Manter, Chief Medical Officer of OU Medicine, said the vaccine is promising, but hopes remain dim as ICU cases continue to grow. According to Mantar, the number of COVID-19 hospitalizations at OU Medicine has dropped from more than 100 per day to 98 on Wednesday in recent weeks.

“Everyone is stressed by watching every week. The plugs aren’t turned off, they don’t know there’s a break, and they don’t see the light of the saying at the end of the tunnel. “

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Contributed by Associated Press writer Marion Renault in Rochester, Minnesota, Noman merchant in Houston, and Ken Miller in Oklahoma City.

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The Associated Press’s Department of Health Sciences is supported by the Department of Science Education at the Howard Hughes Medical Institute. AP is solely responsible for all content.