COVID-19
COVID-19 WAS IN ITS INFANCY -- THERE WAS A GROUP OF 14 PHYSICIANS,
COMMUNITY
REPRESENTATIVES, AND
LAWYERS AND STAFF
MEMBERS WITH IDAHO
DEPARTMENT OF HEALTH
AND WELFARE COMING UP
WITH A PLAN.
A PLAN FOR WHAT TO DO
IF THE STATE'S HOSPITAL
CAPACITY REACHES A
CRISIS LEVEL.
DR. KENNETH KRELL WITH
EASTERN IDAHO
REGIONAL MEDICAL
CENTER WAS PART OF
THAT GROUP.
HE TOLD ME TODAY --
ESSENTIALLY WHAT IT MAY
COME DOWN TO -- IS A
SCORING SYSTEM TO
DECIDE WHICH PATIENT
GETS THE MEDICAL CARE
THEY NEED AND DESERVE
-- AND WHICH ONE
DOESN'T.
DOESN'T.
"THIS
"THIS HAS
"THIS HAS BEEN A RATHER GRIM, MORBID TASK FOR US TO UNDERTAKE TO
DECIDE HOW WE WOULD
ALLOCATE RESOURCES
WHEN THEY BECOME TOO
SCARE TO BE ALLOCATED
TO ALL DESERVING
PATIENTS," SAID DR.
KENNETH KRELL, STATE OF
IDAHO MEDICAL ADVISORY
COMMITTEE
"SO WE CAN'T JUST LOOK
AT THE NUMBER OF ICU
BEDS THAT WE HAVE
AVAILABLE. WHAT WE
HAVE TO LOOK AT IS THE
NUMBER OF STAFF THAT
ARE AVAILABLE TO TAKE
CARE OF THOSE PATIENTS
AND
AND WE
AND WE ARE QUICKLY RUNNING OUT OF STAFF IN THIS STATE," DR. KRELL
SAID.
KIM SAYS, "AND
ESSENTIALLY THE CRISIS
STANDARDS IS LIKE A
SCORING SYSTEM,
DOCTOR, WITH POINTS
ASSIGNED TO PATIENTS,
AND THEN THAT
DETERMINES IF AND WHEN
THEY'LL BE GETTING THE
CARE, IF IT GETS TO THAT
POINT?"
"THERE ARE A LOT OF
GUIDELINES OUT THERE
THAT WE LOOKED AT AND
ADAPTED AND THAT
INCLUDES SUCH THINGS
AS WHAT'S THE PATIENTS
LIKELIHOOD OF
SURVIVING ON AN
IMMEDIATE BASIS. AND IF
THEY DON'T HAVE A
LIKELIHOOD OF
SURVIVING COMPARED TO
SOMEONE ELSE, THEN
THEY'RE GOING TO BE
ALLOCATED TO
COMFORTABLE CARE, THAT
IS TO MAKE THEM
COMFORTABLE," DR. KRELL
SAID.
"AND THEN IF YOU END
UP WITH A TIE, YOU HAVE
A NUMBER OF TIE
BREAKERS.
BREAKERS. PREGNANT WOMEN, NOT HAVING BEEN THROUGH ALL YOUR
LIFE CYCLES, THAT IS A
WAY TO ALLOCATE BASED
ON AGE, AND A NUMBER
OF OTHERS. AND THEN IF
YOU HAVE A TIE THAT
RESULTS AT THAT POINT,
THEN THERE IS A LOTTERY
SYSTEM TO DECIDE WHO
GETS THE SCARCE
RESOURCE," DR. KRELL
SAID.
KIM ASKS, "ARE YOU
BEING AN ALARMIST OR
ARE WE REALLY CLOSE TO
HAVING TO IMPLEMENT
THIS TYPE OF CRISIS
STANDARD?" "I THINK IT'S
TELLING THAT GOVERNOR
LITTLE HAS ESSENTIALLY
STATED, HE'S THE FIRST
ONE WHO USED THAT
TERM, THAT WE ARE AT A
TIPPING POINT," DR. KRELL
SAID.
KIM ASKS, "BUT AGAIN,
GOING BACK TO THIS
CRISIS STANDARD, AND IF I
WALK INTO A HOSPITAL
AND WELL, NOPE YOU
HAVE THIS, WELL, NO,
LET'S TAKE THEM INSTEAD
OF YOU. I MEAN, HOW
CLOSE ARE WE TO
COMING TO THAT HERE IN
IDAHO? "WE'RE NOT
EXACTLY SURE. WE ARE
MEETING AS A STATE OF
IDAHO MEDICAL ADVISORY
COMMITTEE TOMORROW
COMMITTEE TOMORROW
TO
TO DISCUSS THOSE ISSUES," DR. KRELL SAID. "BUT CLEARLY WHAT WE
HEAR FROM AROUND THE
STATE IS THAT RESOURCES
ARE STRETCHED AS FAR AS
WE CAN. AND THAT WE
ARE APPROACHING THE
LIMITATION OF WHAT WE
CAN PROVIDE IN TERMS
OF THE USUAL CARE THAT
WE PROVIDE," DR. KRELL
SAID.
KIM ASKS, "I JUST CAN'T
EVEN BELIEVE WE'VE COME
TO THIS." "WE HAVE
UNFORTUNATELY," DR.
KRELL SAID.
THE WIDESPREAD
PRESENCE OF COVID-19 IN
IDAHO IS ALREADY
LIMITING THE TYPE OF
USUAL HEALTH CARE
THAT'S PROVIDED.
BEGINNING TODAY, ST.
LUKE'S TEMPORARILY
STOPPED ELECTIVE
SURGERIES AND
PROCEDURES THAT
REQUIRE AN OVERNIGHT
STAY.
NO SURGERIES -- LIKE
HYSTERECTOMIES OR
KNEE REPLACEMENTS --
FOR THE NEXT SIX WEEKS.
AND -- SAINT
ALPHONSUS SAYS THEY
HAVE BEGUN TO
SELECTIVELY LIMIT
CERTAIN SURGICAL
PROCEDURES AT THEIR
BOISE
BOISE HOSPITAL. THE PROBLEM ISN'T SO MUCH ACTUAL SPACE OR
THE NUMBER OF BEDS OR
EQUIPMENT. IT'S
STAFFING.
BRIE SANDOW, DIRECTOR
OF RESOURCE AND
STAFFING AT ST. LUKE'S
TOLD ME THEY'RE OUT
MORE THAN 100 STAFF
TODAY...
KIM, "SO WHAT DO YOU
DO WHEN YOU'RE 100
EMPLOYEES SHORT?"
EMPLOYEES SHORT?"
"THAT'S
"THAT'S AN EXCELLENT QUESTION. WE HAVE EXCEPTIONAL TEAM WORK
AND THAT IS THE START
ON HOW WE'VE COME
AROUND THIS
CONSISTENTLY DAY AFTER
DAY. BUT THERE'S A FEW
DIFFERENT TACTICS. 4:15
THE MOST OBVIOUS ONE
IS WE ASK OTHER STAFF
TO WORK EXTRA :19
ST. LUKE'S IS CURRENTLY
EXPERIENCING THE
HIGHEST NUMBERS OF
STAFF ILLNESS AND STAFF
OUT WITH COVID-19
SINCE THE PANDEMIC
BEGAN IN MARCH.
THE HOSPITAL IS RELYING
ON THEIR FLOAT POOL OF
RESOURCES, THEIR
BACKUP NURSES. AND
THEY'VE CALLED IN
TRAVELING CONTRACT
NURSES FROM OUT OF
STATE. BUT EVEN THOSE
ARE HARD TO COME BY.
AND SO WHEN THOSE
NURSES HAVE BEEN
WORKING
WORKING CONSISTENTLY SINCE MARCH, THEY'RE EXHAUSTED. SO WHAT
WE'VE SEEN NOW IS
SUPPLY AND DMEAND.
THESE NURSES ARE TIRED,
THEY'RE
THEY'RE FATIGUED. AND THEY'RE NOT WANTITNG TO EXTNED CEONTRACT.
THEY WANT TO GO HOME
AND TAKE A BREAK 8:15
AND SO THAT HAS
PRESENTED ANOTHER
LEVEL OF COMPLEXITY BC
HISTROICALY IT HAS NOT
BEEN THIS MUCH OF A
CHALLEGE TO BRING IN
EXTERNAL NURSES :25
AND THEN HOW DO WE
INCENTIVITEZE OUR
EXSISTING NURSES, BUT IN
A WAY THAT THEY AREN'T
OVERLY FATIGUED OR
BURNED OUT. AND
THAT'S A REALLY FINE
BALANCE :47 IN TERMS OF
BEING ABLE TO MEET OUR
PATIENT CARE NEED. 8:51
LET'S TALK ABOUT HTAT,
THAT BURNING OUT AND
NOT WORKING THEM TOO
HARD. WE HEAR OF
AIRLINE PIOLTS. THE FAA
SAYS YOU CAN FLY THIS
MANY HOURS AND THEN
YOU'RE GROUNDED. ARE
THERE REGULATIONS LIKE
THAT IN PLACE FOR HEALT
CARE WORKERS, FOR
NURSES AND DOCTORS?
9:07 SO THERE ARE NOT
LEGAL RELGULATIONS IN
PLACE IN THE SAME WAY
THAT THERE ARE FOR THE
FAA, ALTHGOUHN AS
HEALTHCARE WORKERS
WE OFTEN LOOK TO
THOSE PRACTICES AS
IMPORTANT GUIDELEINES
FOR THE CARE THAT WE
PROVIDE. :20 AT ST. LUKE'S
WE DO HAVE GUIDELINES
IN PALCE THAT WE UTILIZE
UNDER NORMAL
CIRCUMSTANCES IN TERMS
OF BOTH THE NUBMER OF
HOURS SOMEONE CAN
WORK WTIHIN 24 HOURS
AND THE NUMBER OF
HOURS THEY NEED OFF
BETWEEN SHIFTS AND THE
NUBMER OF HOURS THEY
CAN WORK IN
CONSECTUVIVE DAYS.
WHAT I CAN SAY THOUGH
IS THAT WEHN WE ARE
PUSHED TO A POINT
WHERE WE DON'T HAVE
THE HEALTH CARE
PROVIDERS AVAIVLE FOR
THE VOULMES, WE HAVE
TO ADJUST. AND SO WE'RE
NOT ABLE TO MAINTAIN
THOSE SAME GAILDELINES
CONSISTENTLY 9:54
WE HAVE BEEN
INCREDIBLY INTENTIONAL
IN GETTING THE
RSOURECES THAT WE
NEED TO SAFELTY CARE
FOR THE PATIENTS BUT
NOT UTILIZEING
ADDITIONAL RESOUCES
BEYOND THAT :13 WE
UNDERSTAND THAT IN
TERMS OF COVID AND
WINTER, THIS IS GOIGN TO
BE A MARATRHON AND
NOT A SRPINT AND SO WE
ARE VERY COGNITIVE OF
CARINF FOR OUR STAFF
:23 AND WANTING THEM
TO CARE FOR
THEMSELEVES ALSO SO
THEY DONT GET SICK :29
THE PUBLIC WANTS TO BE
FOUCSED ON COVID AND
WHAT'S GOING ON COVID.
.. WHAT'S THE NET
CAPACITY FOR ANYONE IN
OUR COMMUNITIES THAT
REQUIRES
REQUIRES CARE. :41
WE
WE CHECKED IN TODAY
WITH
WITH ST.
WITH ST. LUKE'S MAGIC VALLEY IN TWIN FALLS. THEY WERE ON AND OFF
ICU DIVERSION
THROUGHOUT THE
WEEKEND.
THEY CAME OFF IT THIS
MORNING, BUT AS OF 2:15
THIS AFTERNOON -- THEY
WERE BACK ON ICU
DIVERSION.
STAFFING IS THE MAJOR
DRIVER,