Holy cross

Sainte-Croix is ​​still dealing with Omicron | Health

As the Omicron wave of the coronavirus wanes across much of New Mexico and across the country, daily COVID-19 case counts and test positivity rates are down in Taos County. But Holy Cross Medical Center CEO Bill Patten said the Taos hospital was not yet ready to move from standards of crisis care to standard operations.

“When we made this announcement [on Jan. 14] it didn’t change anything about what we were doing,” Patten said. “We had been operating to these standards for weeks, maybe a month or two, but we felt it was important for the community to understand the pressure the organization was under. under.”

As part of a larger hub-and-spoke hospital system — with Christus St. Vincent Regional Medical Center in Santa Fe as that region’s referral hospital — Holy Cross is still being pushed to its limits by COVID. This is partly due to an overall shortage of hospital beds in the state, which has in some cases left patients waiting days in the emergency room until they can be transferred elsewhere for a higher level of care. .

“Our ability to transfer a patient with a heart attack or major trauma to major hospitals just wasn’t accepting many of these patients, so we had to hold people back much longer than we normally would” , Patten said. “We had to keep acuity much higher than we normally would.”

At Holy Cross, adopting crisis standards does not mean deciding who receives care and who does not, said Dr John Foster, hospital program director at Holy Cross.

“We don’t make decisions like which patients we ventilate or not,” he said.

“The problem I have on a day-to-day basis is really that the other hospitals in Santa Fe and Albuquerque are within crisis care standards,” and can’t always accept patients from smaller hospitals like Holy Cross, Foster said. . “Usually what happens is if someone needs a specialist procedure, we transfer them to another hospital. Now we can’t get them transferred in a timely manner.

“Here in Taos, we could usually get them to Colorado Springs or Denver,” Foster added. “But now Colorado won’t take them because they’re also full.”

And Patten said the hospital is still seeing an influx of COVID-19 patients. He echoed what health officials, including the Secretary of State for Human Services and Acting Health Secretary Dr. David Scrase, have said throughout the pandemic: The spikes in Hospitalizations tend to materialize two to three weeks after a spike in infections. Deaths tend to start rising about four weeks after a spike in new infections.

“Last week our [COVID patient] the numbers were down, and this week I wouldn’t say they’re going up, but they’ve come back up a bit,” Patten said. “We have a patient, related to COVID, who’s on a ventilator, [and] I think we had eight COVID-positive patients in the building this morning,” three of whom were in intensive care beds.

Holy Cross is a 25-bed critical access hospital with 15 medical/surgical beds, six intensive care beds and four labor and delivery beds. Operating to crisis standards allows greater operational flexibility in capacity.

“Under the declaration of emergency, we weren’t bound to a specific number when it came to our licensed beds,” Patten said. “So it’s not uncommon for us to have slightly more patients than we’re allowed to – even now.”

Patten said staffing those beds can be a challenge on some days.

“The area that’s been a problem for us since the start of the year is the number of employees testing positive,” Patten added, with “eight or nine positive tests in the last few days alone” despite a high percentage of hospital staff. be “both vaccinated and boosted”.

A nationwide shortage of nurses and other licensed clinical staff continues to plague the hospital, which currently employs 41 traveling nurses, nearly half of its nursing staff. Traveling nurses cost the hospital up to two or three times more, a situation that is not sustainable.

In a letter last week, the American Hospital Association asked Congress for ‘additional resources’ to help health care systems and hospitals deal with mounting financial pressures, specifically citing the expense of employing nurses. of travel.

“Unfortunately, some travel nurse recruitment agencies appear to be exploiting these shortages by inflating prices beyond reasonably competitive levels – two or three times or more pre-pandemic rates – and maintaining high profit margins for themselves,” the letter reads.

In line with national trends, Patten said Holy Cross staff have seen an increase in aggressive behavior as patients and their families express frustration at, for example, extended wait times for beds or transfers. to a larger hospital.

“In the beginning, we were healthcare heroes,” Patten said. “Now they insult us, they spit on us; somehow we are seen as the problem. »

Overall, the number of “COVID-related” patients seen in the emergency department has dropped significantly, with less than 20% of all emergency department visits now classified as COVID-related.

“At one point [during the Omicron surge] it was easily 30-40% overall, a few more days,” Patten said.

Foster warned that, in Taos County, “even though the numbers are coming down, even though it looks like we’re past the peak, they’re still quite high.”

Additionally, patients at Holy Cross are sicker than they have been in the past, a phenomenon largely due to the fact that so many people have delayed routine health care during the pandemic.

“One thing people can do is continue to stay up to date with their primary care and see their doctor when they need to,” Foster said. “We don’t want people delaying care.”

New Mexicans who might be ready to drop their masks and get back to normal should think twice before letting their guard down, said Dr. Cipry Jaramillo, hospitalist and chief medical staff at Holy Cross.

“It’s not over until everyone in the world is vaccinated and protected,” she said. “Until that happens, we’re still in the same place.”

“The truth is, we don’t know what’s going to happen,” Foster agreed, adding that he “would love to relax and drop the mask mandate. But I think at this point it’s wise to follow the guidance from the Department of Health. They’re delaying [dropping the mask mandate] because in New Mexico we have to be even more careful due to resource constraints in our healthcare system.”