Staff members aim to keep Kansas hospitals afloat amid COVID-19 surge

Andrew Bahl
Topeka Capital-Journal
Janelle Williamson, a palliative care advance practice registered nurse, puts on her last pieces of personal protective equipment before entering a COVID-19 patient within the intensive care unit of Stormont Vail Hospital on Thursday. Stormont, like hospitals statewide, has been dealing with a flood of COVID-19 patients.

Kansas nurses have seen a lot of heartbreak in the past 15 months.

Every time there appears to be a lull in the COVID-19 pandemic in the state, a new set of challenges have been right around the corner.

For Adam Tebben, the latest round of painful moments entails watching patients, potentially on a ventilator and dealing with severe complications from the virus, beg for a COVID-19 vaccine.

"Unfortunately, we tell them, you know, it's not going to do you any good, we have to treat your symptoms now," said Tebben, a clinical nurse coordinator at Wesley Medical Center in Wichita.

Tebben isn't normally the person to deal with intensive care patients. But the rise in the number of serious virus cases has forced them into the emergency room where he and his colleagues work, sometimes for hours at a time — or longer.

More:KDHE issues Kansas COVID-19 rankings to aid local leaders. How does your county compare?

Vaccination rates statewide are increasing, although not fast enough to bring Kansas back from the brink of the situation it finds itself in. Hospital beds in the most populated parts of the state have filled up and while the more serious situations, encountered by health care workers in the deep south and Texas, have been avoided, it is unclear what the future holds. 

That heightens the frustration Tebben feels when he hears misinformation about the virus from family members of the same patients he is caring for, the same folks pleading for a vaccine.

"It's really tough to sit there and do our job," he said. "And we're fighting to make sure that people are taken care of and we can't do our best at it because we're having huge influxes of these patients. And it really hits home and you wish that you could just bark at them and tell them, 'Hey, you need to get vaccinated, because that might be the difference between you and what your loved one's going through right now.'"

The feeling of frustration, pain and exhaustion has spread among nurses like Tebben, as well as other health care workers in the state. Public goodwill and appreciation for frontline workers has ebbed after the early days of the pandemic and some say they don't feel taken care of by their employers, who are asking them to live up to the tall task of coping with a fourth wave of cases many thought — or hoped — would never come.

"Nurses feel that they're being taken advantage of, by anti-vaxxers, especially when they need our direct care," said Kelly Sommers, president of the Kansas State Nurses Association. "Some feel like they're being taken advantage of by their employers. And many think they're being taken advantage of by their local and state government."

Amid COVID-19 crunch, hospitals spend hours searching for beds

The rise in cases associated with the variant has put hospitals throughout the country in a position they haven't found themselves in since winter. 

Kansas is no exception to that trend. The number of new cases per day is at levels not seen since January and while these figures are a decline from where they were in November and December of 2020, experts fear things are heading in the wrong direction.

"We're starting off with our beds already full, so as the day goes along, now during the pandemic, they start piling up into our hallways, into our waiting rooms," said Chad Cannon, chair and clinical service chief of emergency medicine at the University of Kansas Health System. "We can't get patients out of the ER and into the hospital because the hospital is full. It's a very tough situation for everybody."

And hospitals are in as dire straits as they were during the peak of the pandemic. This is in large part due to staff, which has been hard hit by burnout, leading some to leave the profession and putting strain on a sector, which was already understaffed.

More:'Our hospital is full': Stormont Vail CEO warns of dire situation amid Kansas COVID surge

This has had real effects on hospital operations statewide.

Officials at a hospital in Abilene had to move a COVID-19 patient to Wisconsin in order to find a bed. Both of Topeka's largest hospitals say they have hit peak capacity and have had to divert patients, even those without the virus, to other facilities in the region. And one of them, Stormont Vail Hospital, has brought in a mobile morgue in preparation for where their situation is headed.

One of the hospitals receiving patients from Topeka is Ascension Via Christi in Manhattan, with hospital president Robert Copple saying they had the capacity to step up and take transfers from their larger peers 50 minutes away.

But Copple said his facility has also been coping with capacity problems at times in recent weeks. At one point they had to transfer a patient to Kearney, Neb., just to find them a bed.

While most patients come from the Manhattan area, the hospital also has had to step up and bring aboard individuals from rural hospitals in north central Kansas, with those facilities quickly tapped out in the level of care they can provide.

At Community HealthCare System in Onaga, the closest available beds found for a patient were in Chicago and Idaho, although the hospital elected to keep the patient in-house over fears he couldn't be transferred safely.

It took over three hours to find a transfer for a different stroke patient. And another individual drove from Oklahoma in search of a bed.

"I heard someone who works here say 'I have two people in my family who farm and I just pray they don't have an accident right now because I just don't know what will happen,'" said Sarah Hancock, the hospital's communications director. "That's not something I'm used to hearing hospital staff say. You can tell that worry is really wearing/ It is right there in the foreground all the time."

Hospitals across the state are able to update their capacity online and share any bed availability with their counterparts using a software rolled out by the state last year.

More:COVID outbreaks close Kansas school district. What happens next, and will there be more?

More:Kansas reports 5 school COVID-19 clusters in the past week. None were publicly identified.

But even if there should theoretically be space available at a peer hospital, there are no guarantees the rapidly evolving situation on the ground will mean a bed will be open at any given moment. Copple pointed to a recent example where he called every hospital reporting availability in the state, in a bid to find a bed for a stroke patient and an individual suffering from seizures.

The first round of calls produced nothing. And while a second attempt did find space in Topeka, it was still a harrowing experience — and one that is indicative of the current state of affairs, he said.

"Everybody got taken care of. It just took a lot of work to get that done," he said. "That's kind of this whole challenge every day is: 'What's going to happen today? What are the resources today?' And trying to match that all up."

At Holton Community Hospital, the lack of area capacity has forced them to take on sicker patients than normal, stressing out staff who aren't used to working with ventilators, for instance. And the problems are compounding — the hospital is facing a shortage of medical tubing due to the volume of patients, as they have used far more than their normal supply.

"I think everybody's tired of reading about it, hearing about it, talking about it," CEO Carrie Saia said. "But right now, it's worse than it ever has been."

Nurses aim to keep hospitals afloat amid virus resurgence

The problem for many hospitals isn't necessarily a lack of space, although that is starting to again become an issue for some facilities.

But instead, there simply aren't the requisite number of staff members available to staff every bed in a given hospital. Nurses, aides and anesthesiologists who have worked double shifts and weekends for 15 months are continuing to wear down.

Mental health challenges are rampant, said Sommers, of the Kansas State Nurses Association, and not all health systems are in a place where they can support their employees — even after being called frontline heroes for over a year.

More:Are you looking for COVID-19 vaccines and testing in Kansas? Here's what you need to know.

"Right now, the profession of nursing has already been hurt by COVID," she said. "But nurses also have solutions, especially when it comes to staffing. But what we're seeing is that our leaders are not bringing us to the table to have those discussions, discussions, and talk about decision making."

Tebben said Wesley has been supportive, offering counseling services, and managers will attempt to reach out if they see a person struggling, although he notes the stigma surrounding mental health issues remains high.

But even still, one of his colleagues recently died by suicide and while he isn't sure that it was related to the pandemic stress, he believes it played a role. The mental health strain isn't uncommon — according to a recent survey by the Kaiser Family Foundation, 60% of frontline health care workers said the pandemic has affected their mental health, with the poll conducted even before the recent delta variant surge.

"Just looking at people in the faces, being able to know what they're usually like on a good week versus here recently, you can tell that people just feel defeated," Tebben said.

Nurses exit profession for traveling jobs, other work after virus stress

The pandemic-related struggles has prompted an exodus of nurses from the profession, industry officials say.

While some leave the industry entirely, others leave to go work as a traveling nurse, where they can make more money. Ironically, traveling nurses are in sky-high demand due to the staff shortage nationally, costing hospitals thousands of dollars per week.

"It is travel jobs that are providing incentives that nurses need and the feeling of being more appreciated than they are right now," Sommers said.

The push for these traveling nurses has created a competitive market, leading to concerns Kansas will be outbid by larger, hard-hit states.

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"You got states like Texas and Florida paying a fortune for a contract nurses," Gov. Laura Kelly said at a news conference on hospital issues Friday. "So we're gonna end up in a bidding war with other states."

At Wesley in Wichita, bonuses and more money for taking on extra shifts were initially a boon, Tebben said. But those days have quickly faded, as family time and rest have taken precedence.

"At first, that was great," he said. "We're getting paid a lot more to come in for our extra shifts. But then again, right now, I'm seeing a lot of people not want to pick up just because of the stress that comes with it.

"And you know, the money isn't everything."