‘We’re scared’: Yakima Valley Memorial Hospital at a breaking point

YAKIMA, Wash. — Yakima Valley Memorial Hospital is experiencing the worst surge in COVID-19 patients they’ve seen during the pandemic.

“We’re scared. I don’t know what else we can say,” said Dr. Marty Brueggemann, Chief Medical Officer at the hospital. “I don’t think people understand how fragile the system is right now.”

The hospital has 226 licensed beds, but not all of them can be used at this time. Some are specialized beds in the psychiatry ward or labor and delivery floor that can’t be used for just any patient.

Brueggemann said even if they were able to put COVID-19 or other patients in those specialized beds, the staff on those floors don’t have the training to be able to manage them.

RELATED: Yakima Valley Memorial: 25% of patients have COVID-19

While most of the hospital rooms have two beds, some rooms can’t have a second person because men and women can’t be placed together, an immunocompromised person needs to be in isolation or a person has an infectious disease — such as COVID-19 — and could be at risk of spreading it.

“These factors mean that it is nearly impossible to get to the number of 226; anything over 190 is essentially a full house,” Brueggemann said.

As of Wednesday, the hospital had 198 patients, with an additional 15 admitted patients staying in emergency room beds while they wait for a room to open up. Nearly 50 of those patients — one out of every four in the hospital — has COVID-19.

Brueggemann said on any given day, they have anywhere from 20 to 30 people in the ER waiting room. Right now, Yakima Valley Memorial Hospital has the second busiest emergency department in the state.

“If you’re lucky, you’re going to get back and probably get taken care of on a hallway stretcher, in the middle of the hallway with a lot of other people around,” Brueggemann said.

Brueggemann said they only board patients in the ER if no other beds are available. The hospital also has a limited number of monitored and Intensive Care Unit beds, so if a patient requires that level of care, they don’t have the right beds to care for them.

“We have patients who have been sitting in our ER for a day or two at times waiting to go to a tertiary care center like Harborview or UW,” Brueggemann said. “We can’t get them there because they don’t have beds either.”

RELATED: Yakima hospital ‘in crisis’ as COVID-19 patients surge

Brueggemann said another concern with the high patient volume is that the hospital’s infrastructure can only support so many lines for high-flow oxygen. Staff have to keep spreadsheets for each floor to document how much oxygen is being used on each floor of the hospital.

“When a floor source gets too high, then we have to say, ‘Okay, this floor can’t take another high flow oxygen patient, because otherwise the whole system goes down,'” Brueggemann said.

Brueggemann said once the beds with high flow oxygen lines are full, they’ll transition to using oxygen tanks — which get used up quickly. With other hospitals across the country facing similar problems, those tanks will likely be in short supply.

“Then you don’t have the supply infrastructure to keep up,” Brueggemann said. “At some point, you will get to that rationing of care discussion — what we call crisis standards of care.”

Brueggemann said if it gets there, they will have to start making decisions about who gets the resources and who doesn’t.

“That’s a place we never want to get,” Brueggemann said. “For the first time during the pandemic, I can actually see how that could happen here.”

Health care workers have been leaving the profession at record rates in response to the stress and pressures of caring for COVID-19 patients. The doctors, nurses and other medical professionals who have stayed are overwhelmed, frustrated and struggling with burnout.

“There’s nothing worse than showing up day after day, coming in on your day off, staying over, working two shifts in a row, just to fill these holes and then leave and find out that your community doesn’t believe that what you’re doing is real,” Brueggemann said.

Some doctors and nurses across the state plan to leave their jobs in response to Gov. Jay Inselee’s mandate that all health care workers be fully vaccinated by Oct. 18. Brueggemann said judging by the experience other organizations have had, only a small fraction of staff follow through with resigning.

“We won’t know the answer to this one until the deadline comes,” Brueggemann said.

Hospital officials are encouraging community members to wear face masks regardless of vaccination status and to get the COVID-19 vaccine to help stop the spread of the virus and keep the health care system from becoming completely overwhelmed.

The Yakima Health District maintains a list of places where the COVID-19 vaccine is available, as well as a list of upcoming mobile clinics held across Yakima County at yakimavaccines.org.

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