While COVID-19 hospitalizations in Oregon are less than half of what they were at their peak last fall, hospitals across the state are struggling to operate normally.
Hospital executives and state officials say a combination of financial hardship, rising hospitalizations due in part to COVID-19, and severe staffing shortages have led to fewer available beds in some areas. .
Central and southern Oregon have been particularly hard hit, state epidemiologist Dr. Dean Sidelinger told reporters at a news conference Wednesday, particularly St. Charles Medical Center in Bend.
But no Oregon hospital was spared, he said.
Although there may be physical beds available, some hospitals do not have the staff to use these spaces.
“It’s kind of a domino effect,” Sidelinger said.
Oregon health officials are urging residents of 21 counties with high COVID-19 cases — including the three Portland-area counties — to resume mask-wearing to help ease the strain people are under hospitals.
Long hours, full beds
In Bend, 96% of inpatient adult beds at St. Charles Medical Center were occupied Tuesday, with six more ER patients waiting to be admitted to the hospital, according to spokeswoman Kayley Mendenhall.
Patients in need are not being turned away, she said.
Last week, the hospital’s chief medical officer told providers to prepare for “the toughest challenges we’ve seen in the past two years”.
“Now more than ever, we must not have any patient in a hospital bed who does not absolutely need it,” Chief Medical Officer Doug Merrill said in a July 15 email.
Two St. Charles nurses told the OPB their working conditions have deteriorated in recent months, with many providers unable to take scheduled breaks and working up to 16 hours a day in some cases .
“The work environment and staffing at St. Charles, … it got worse, horribly worse,” said Megan Bovi, who has been a registered nurse at Bend Medical Center for 15 years.
St. Charles Chief Operating Officer Iman Simmons said staffing shortages are preventing the health care system from staffing as many beds as it otherwise could.
“Our staffing shortages have really impacted our ability to staff all beds at all times,” she said.
Simmons said some staff are missing their scheduled breaks and “that’s not OK,” while adding that the factors behind employee stress and vacancies are multifaceted.
“I don’t think there’s a good guy or a bad guy,” Simmons said. “I think it’s just a lot more complicated, and it’s difficult and healthcare is going through a crisis, almost an existential crisis when it comes to taking care of their communities.”
Last Friday, St. Charles activated its Incident Command System, a standardized approach to hospital emergencies. The aim was to stabilize the workforce and manage hospital admissions, internal emails show.
Other hospitals in the state are also experiencing capacity issues. Of the Wednesdaystate data shows that only 7% of all hospital beds in Oregon are available.
Becky Hultberg, president and CEO of the Oregon Association of Hospitals and Health Systems, said hospitals are facing a situation as dire as the delta and omicron waves of the COVID-19 pandemic at the end of 2021. and earlier this year when sick patients flooded hospital rooms across the state.
The large number of patients who could be transferred to long-term care centers, but those centers have little or no room, has compounded the problem, Hultberg said. As a result, some patients end up staying weeks in hospital longer than necessary.
Financial challenges for hospitals
Financial difficulties also played a role. The first quarter of 2022 was the worst for Oregon hospitals since the pandemic began, with hospitals reporting a collective $103 million, according to OAHHS.
Rising costs of delivering health care combined with relatively flat incomes have left many health systems struggling to stay in the black, Hultberg said.
“Things are quite challenging from a financial perspective, and that exacerbates that capacity challenge as well,” she said.
St. Charles, for example, has reported a loss of more than $40 million this year so far.
In May, the health system laid off more than 100 employees, while eliminating 76 vacant positions. Two executives were laid off last week as part of cost-cutting measures, hospital officials said.
The remaining positions have been difficult to fill, particularly nursing positions. St. Charles has a systemwide vacancy rate of 15%, while 21% of RN positions are open. An even bigger gap is the rate of certified practical nurses at 38%, according to Simmons.
Simmons said vacancies, people using vacation time and burnout among current staff are all contributing to the understaffing.
Joel Hernandez, a registered nurse at St. Charles for 16 years and vice president of the Oregon Nurses Association in Bend, said hospital staff morale was the worst he’s seen in his career and many are considering leaving. health care completely, if they did. t already.
“They don’t feel like they have a voice,” Hernandez said of his co-workers. “I feel like a number… if [management] Get rid of me, I’m just a number to them.
Simmons said the health system is bringing in 30 travel nurses — who work shorter contracts for premium pay — to help fill the staffing gap.
Oregon isn’t the only state where hospitals are operating at or above their limits.
The Washington State Hospital Association has reported many hospitals are at 120-130% capacity.
Idaho does not publicly provide hospital bed availability, but COVID hospitalization rates have increased in high-risk areas such as Ada County, as reported by the Idaho Statesman. COVID patients there occupied 10% of staffed hospital beds as of Monday.
Jamie Diep contributed to this report.