WARRENSBURG — As the COVID-19 pandemic enters yet another calendar year, the Western Missouri Medical Center staff continue to care for patients despite seemingly endless struggles.
WMMC CEO Darinda Dick spoke with the Star-Journal on Friday, Jan. 28 and said during the past week, 45 different patients had been admitted with COVID, a new high for WMMC. She said the last record-high was in November 2020, with 28 COVID patients in one week.
“We have been very busy and saturated with COVID patients,” she said. “It is starting to slow down a little bit over the last five or six days. The 10 days before that, we were holding anywhere from five to 14 patients in the Emergency Department that needed inpatient beds, which is a lot. We have a 14-bed ER … We’ve overflowed into a different unit. We’ve made some accommodations for that, but it’s really hard to run an efficient ER when you have a backup for inpatient beds. At the same time, it’s a good problem because we do have the nurses, we have the services to care for those patients because there hadn’t been any room in the city to transfer them.”
Those COVID cases have ranged from a hospital stay of just a few days for supportive care to severe cases. Dick said WMMC had several COVID deaths the week prior.
According to Dick, Western Missouri has more than 25 openings for RNs and the hospital used more than $6 million in agency nursing last year to staff its beds. She noted WMMC expanded its bed capacity in August with a commitment to bring in more nurses to staff an overflow unit and to fully staff the ICU so it could admit as many critical patients as possible.
“So that did increase our costs around securing those contract labor nurses, but it has been good to be able to get contract labor,” she said. “But at the same time, it makes it difficult for not only the budget but it makes it difficult to have standard processes. When you have temporary help, it always takes a toll on your consistency of care.”
WMMC still has time to comply with the CMS mandate for all staff members to be vaccinated, and fewer than 100 remain unvaccinated. Dick said that number is still concerning, considering the hospital already has a staffing shortage.
Dick said the staffing shortage is difficult and takes a toll on the staff who have been at WMMC through the entire pandemic. Hospital administrators have been working on ways to show appreciation and help those employees take care of themselves.
On Jan. 28, Dick and other hospital leaders presented two pairs of Chiefs tickets to the AFC Championship game and five getaway trips that included PTO, hotel, airfare and spending money. The gifts went to the top seven people who had the most hours in the last six months of 2021. Seven met the criteria and worked an average of at least 50 extra hours a month.
“Six work on med-Surg. We have some really dedicated nurses there,” Dick said. “Med-Surg has been really full every single day. They’re flexible, they also fill in other places. They’ve been working really hard. It was a mix of techs and nurses. And then we had one environmental services, our floor tech, who just works tirelessly to keep the facility clean. We wanted to celebrate them and thank them for their hard work and give them something that they could enjoy.”
Supply shortages reported in nearly every American industry are affecting WMMC as well.
Dick said WMMC has been experiencing what could be considered price gouging. She offered the example of pre-filled saline flushes. One supplier no longer makes them and the other had some issues, so WMMC had to go to a different market to obtain the item.
“So what would normally cost us $5,000 cost us $35,000,” Dick said. “... We still want to make sure the nurses have what they need because they’re working really hard. They don’t need that extra frustration of not having all of the safety and things that help nurses take care of their patients. So we’ve had to pay more for things, we had to commit to that.”
There is also a drug shortage for COVID treatments. Missouri gets an allotted amount of monoclonal antibody treatments, and currently, WMMC has none, although it has some oral medications for those who qualify.
WMMC has since gotten a shipment of COVID testing supplies, but Dick said just two weeks ago, the hospital didn’t have any rapid tests and was “dangerously low” on PCR testing supplies.
“So we were having to send those out to our testing partner, which delays it from a two-hour turnaround to maybe three or four days,” she said. “And so then people don’t have the diagnosis they need, we don’t know how to properly isolate them and may have to isolate longer than necessary.”
However, the most concerning shortage remains the availability of staffed beds across the region. Dick said it is a significant concern for rural hospitals.
“When we’re (rural hospitals) at capacity or have a patient that’s beyond our capabilities and our regional centers are closed because they are at capacity, what do we do with those patients?” she said. “We have had instances where we couldn’t get a patient transferred that needed care that we absolutely could not provide. That takes a lot of coordination through the hospitals and CEOs; we have stayed in close contact to try to coordinate care like that.”
Dick said WMMC only had one patient who staff thought should’ve been transferred much sooner. She said the patient was transferred and it “wasn’t completely untimely,” but it would have been an automatic transfer before the pandemic.
“That was enough to scare us because what if it was a heart attack or something different?” she added.
WMMC is still giving COVID vaccines through primary care physicians but is no longer hosting large-scale events for the public. Dick said there isn’t a shortage in the vaccine supply and noted Johnson County increased its vaccination rate, but it is still below 40% fully vaccinated. Many of the COVID vaccines being given currently are booster shots to those who were vaccinated last year.
“It’s still sort of a slow effort,” Dick added.
Dick said she and the rest of the WMMC staff are asking for patience from the community. She urged people not experiencing a medical emergency to see their primary care provider first, then try Express Care, noting the ED should be a last resort.
Express Care uses Save My Spot for patients to reserve a time to be seen, but even those spots are filling up quickly. The clinic was full by 3 or 5 p.m. each day for two weeks last month.
“And when I say fill up, it’s a provider seeing 60-plus patients in a 12-hour shift. They try to see as many patients as they can, but when those spots fill, they fill and they close the spots,” Dick said.
“… (We’re asking for) patience with the whole system because we’re dealing with a lot of barriers between staffing and supplies and sheer volume,” she added. “We really are doing the best we can and are trying very hard to give the best care and continue to keep that standard of care where it needs to be. I know it can be frustrating for the patient and family, but it’s frustrating for us too. We’re just encouraging patience.”