Last Friday morning, Linda Cornejo, manager of nursing operations at St. Joseph Hospital in Lake Saint Louis, checked in with nurses working in the hospital’s ICU, medical-surgical, and COVID-19 units. It was a welfare check of sorts. She asked: How are you doing? Are you hanging in there? Where are you at right now?
“They are tired,” Cornejo says. “They are very tired. We have seen an uptick in the census and all of the nurses have picked up additional shifts to help out with that.”
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Last week, Dr. Alex Garza, leader of the St. Louis Metropolitan Pandemic Task Force, announced that hospitals were operating at 90 percent capacity, as Missouri set records for COVID-19 admissions. Over the weekend, a Franklin County boy became Missouri’s first child (younger than 18) to die of COVID-19. On Sunday, Missouri hit a record number of COVID-19 hospitalizations (1,649 people hospitalized) for the fourth day in a row, and, as the task force announced, St. Louis City had more than 400 confirmed patients hospitalized with COVID-19.
Cornejo says that their hospital typically operates at 75 percent capacity. She explains it like this: When people are admitted to the hospital for
surgeries, there is a bed available for an incoming patient. “What is different right now, particularly over the last two weeks,” she says, “is the sheer volume and the acuity of patients coming in. Say we have somebody coming in that needs to be in our Intensive Care Unit, maybe on a ventilator—we are one in, one out.”
She gives this example: That Friday morning, beds in the hospital’s ICU were full when a patient who had suffered a heart attack came in. Intensivists and physicians had to decide which patient could possibly be moved from the ICU down to another unit.
In a previous press conference, Garza noted that more hospitals are seeing transfers from rural areas. Cornejo says patients Lincoln and Warren counties as a large part of the hospital’s surge in admissions. Back in March, the Lake Saint Louis hospital staff saw fewer cases than St. Louis County hospitals and Corenjo says this has helped them prepare and create plans for surge in rural cases they are treating now.
In St. Louis City, Saint Louis University Hospital emergency room nurse Amanda Degreeff says, emergency departments (especially ones that receive transfers from other hospitals) are often full—pandemic or not. At the beginning of March, she did see a dip in emergency room admittance, most likely when there were reports of people avoiding the hospital out of fear of contracting coronavirus. Otherwise, to her, the emergency department’s capacity has seemed the same throughout 2020. The main difference during the pandemic for an emergency room worker (in addition to masks at all times), she says, is having to evaluate whether or not someone fresh off the ambulance is a COVID-19 patient.
Health care workers, particularly ones who work in a trauma center, have a stressful job, to begin with, Degreeff says. She points to another stressor festering alongside coronavirus: “I would say the violence in St. Louis has been a lot higher [during the pandemic],” she says. “It’s been a lot more gunshot wounds and stab wounds than I would say we have in the past. We would have days that the trauma [centers] were just crazy.”
St. Joseph Hospital in St. Charles is also seeing the number of patients admitted increase. But palliative nurse Heather Stock says it’s not just COVID-19 diagnoses. “Some people call it the ‘COVID side effect,’” she says, “those that are being impacted because of the socialization, things like that. Our patient population is thicker. We have quite a number of patients that are either passing away in the hospital or leaving on hospice.”
When we talk, Stock, who works with patients at their final stages of life, is on vacation to rejuvenate and spend time with family. She’s experiencing the same potential burnout Cornejo is seeing with caregivers in Lake Saint Louis. “Their main concern,” she says, “is, How do we sustain this? How do we continue on? How long is this going to be?
