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St. Peter's Health dealing with limited capacity, staffing constraints as patient numbers surge

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Amy Brown, a registered nurse with St. Peter’s Health, says she and the people she works with have been preparing for months, knowing they were likely to see the same time of spike in COVID-19 cases that other hospitals have faced.

“I think for us, it’s been watching the whole nation experiencing this surge of patients and thinking, ‘When is our surge going to hit? When is it going to hit?’ and preparing for it but not really knowing what that’s going to be like or what that’s going to mean for you as a nurse or for the community,” she said.

Now, St. Peter’s leaders say that surge has arrived. Dr. Shelly Harkins, chief medical officer and president of the regional medical center in Helena, said, as the number of patients they’ve seen has gone up, they have shifted operations into a “surge plan.” Still, she said there have been times in recent weeks when they have not had any available beds for patients.

“It’s hour by hour, not even day by day or shift by shift,” said Harkins. “It is literally hour by hour.”

Web Extra: Dr. Shelly Harkins

Harkins said, as of Friday morning, St. Peter’s was caring for 11 COVID-19 patients. That number has generally been between 11 and 16 patients. According to a Montana state report from Thursday, St. Peter’s also had 80 non-COVID patients, leaving only a few of its 99 beds still open.

Another challenge has been staffing. Harkins said they have had 30 to 50 employees who haven’t been able to come to work because they or their family are in quarantine.

“Effectively, all of our service lines are very thin and very stretched,” she said.

Starting this week, St. Peter’s has begun contacting patients to cancel planned elective surgeries. Harkins said they delayed surgeries in the spring as a way to “flatten the curve” of COVID infections, but they hoped they wouldn’t have to take that step again.

“We’re having to do that now simply because the capacity is such that we won’t have a bed for those patients when they come out of the operating room,” she said.

Harkins said the pandemic also meant the hospital has to use more of its beds for non-COVID patients, since most nursing homes are not accepting new admissions.

“We get a bottleneck of nursing home patients that cannot be discharged,” she said. “They don’t need a bed, but there’s nowhere else for them to go.”

St. Peter’s is currently working on securing waivers to potentially open up beds in other areas of the hospital that are not typically used for these types of admissions.

Brown, who has worked with COVID and non-COVID patients on the hospital’s medical floor, said she’s proud of the job she and her fellow frontline workers have done. Still, she said this time has been stressful for a number of reasons – from the constantly changing situation to the need for more specialized staff to help critically ill patients.

“I think there’s a huge mental aspect of it, thinking to yourself, ‘How long will this last?’” said Brown. “There’s kind of a guilt with it, too, because you know if you don’t pick up or work extra, that the people that you work close with are struggling with staff shortages and those sorts of things.”

Web Extra: Amy Brown, a St. Peter’s nurse

Brown said she was initially worried about the possibility of contracting COVID-19 at work, but that she now feels comfortable with the masks, face shields and other personal protective equipment she uses. However, she said she’s still concerned about the virus when out in the community. She urged everyone in the Helena area to take the pandemic seriously and do what they can to relieve the burden on the health care system.

“We all need to work together as a community to slow the spread as much as possible so that not just for you, but your friends, families, neighbors, people that you care about, are able to get the care that they need, even if it’s not related to COVID,” she said.

Harkins echoed that request, saying that – unless the situation improves – they’ll essentially have to ration care.

“Regardless of whether you have COVID or know anyone with COVID or care about COVID, this will still affect your care and the care of your loved ones if we don’t get a handle on this and start to see some improvement,” she said.