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Patients enduring prolonged hospital stays awaiting transfer

February 1, 2023 by Marcy Stamper

Three Rivers CEO: basic civility would be helpful

Okanogan County health care providers and hospitals aren’t currently seeing severe cases of COVID or respiratory diseases like flu and RSV (respiratory syncytial virus), but county hospitals are nevertheless straining to provide appropriate care for people with serious health issues.

Okanogan County hospitals like Three Rivers in Brewster and North Valley in Tonasket are equipped to treat patients who don’t need specialized care, but people who need an intensive-care unit or transfer to a higher-level facility in Wenatchee or Seattle often wait several days for a spot, North Valley Hospital CEO John McReynolds told the Okanogan Coalition for Health Improvement (CHI) last week.

The hospitals have to triage which patients’ needs for an ICU are most urgent. That means patients with serious health issues stay longer in a local emergency department or are admitted to a county hospital while they await a room in a higher-level care facility, McReynolds said. Local hospitals aren’t designed to provide that level of care, Three Rivers CEO Scott Graham told the CHI.

This issue of insufficient capacity is not only affecting small, rural hospitals, but it’s also an issue across the state and country, McReynolds said. While hospitals have enough beds, they don’t have the staff — primarily nurses — to care for patients, he said. Some larger hospitals have closed wings because they can’t afford to pay traveling nurses to fill in, Graham said.

Confluence Health, which operates Wenatchee Valley Hospital, saw increased demand at walk-in and emergency departments in December, although those departments have now returned to typical levels, Confluence Corporate Communications Program Manager Adam MacDonald told the Methow Valley News.

The increased demand resulted in longer-than-normal wait times, but Confluence Health hasn’t denied anyone access to care, MacDonald said. Confluence isn’t experiencing a shortage of providers and continues to hire to expand access, he said.

The provider shortage also affects patients after a hospital stay who need rehabilitative care before they can go home. Patients sometimes spend additional days in the hospital while waiting for placement in a long-term care facility.

Need for civility

The shortage in providers goes back years, but the COVID pandemic made it “dramatically worse,” Graham said. Doctors and nurses are accustomed to working long, hard hours, but they need to feel supported. Increasingly, burnout isn’t caused by the nature of the work, but by the treatment of these professionals by the public, Graham said.

It’s hard to come to work if people come in angry about hospital rules or masking, or if they yell at and ridicule nurses, Graham said. Basic civility and appreciation from the general public would go a long way toward addressing the problem, he said.

There are thousands of vacancies for registered nurses in Washington hospitals, but only 1% of registered nurses in the state are unemployed and looking for a nursing job, the Washington State Hospital Association (WSHA) said in early January.

Addressing this problem isn’t as simple as finding more providers. Infrastructure has been declining over decades, and solutions will take time, Graham said. And, since it’s a nationwide problem, it’s not simply a question of luring providers to this area, McReynolds said.

Today there are more regional educational opportunities for health care careers. Local hospitals and health care facilities are teaming up with high schools and colleges to build interest in health care professions, according to CHI meeting participants.

Wenatchee Valley College offers apprenticeship programs for medical assistants, certified nurses, nursing assistants and registered nurses. Jamie’s Place, which provides long-term care in Winthrop, also helps health care assistants and nursing assistants obtain certification, according to the CHI meeting.

COVID and flu

Because most people today use home tests to detect COVID, up-to-date data are incomplete, Okanogan County Community Health Director Lauri Jones told the CHI. Still, the county sees several cases a day, although most haven’t been serious, she said.

Public Health is following people with long-haul COVID, a condition that’s still not well understood. Many people suffer from symptoms months after they recover from their initial COVID infection, some severe enough that they can’t work, Jones said.

Flu and flu-like illness in Washington was “very high” at the end of December, but new infections have since dropped – they were considered “low” by early January and “minimal” by the middle of the month, according to the state Department of Health. As of Jan. 21, there had been 201 deaths from the disease (four of them children) in the 2022-23 flu season in Washington.

Filed Under: NEWS

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