The worst its ever been: Rural hospital battles COVID-19 with no ventilators
In the rural Nebraska town of Fairbury, doctors and nurses are in a relentless fight to keep COVID-19 under control.
“You know, I would say this round of COVID is probably two or three times as bad as the first rounds,” said Chief Nursing Officer Erin Starr.
Jefferson Community Health and Life is a critical access hospital. That means they have fewer than 25 beds.
“In terms of the pandemic, we have a lot less resources,” said CEO Burke Kline.
Most notably, there are no ventilators in the facility, according to Starr. Very sick patients, therefore, have to be transferred to bigger hospitals in bigger cities.
“We just don’t have the same ability to do things as often as a larger hospital does,” said Dr. Brett Wegin, a family physician.
But with less than 10 percent of staffed adult ICU beds available statewide, patients who need transfers have the odds stacked against them.
“Sometimes we’re sitting on patients, maybe six to seven days,” Starr said.
In the last two months, Jefferson Community staff has had no choice but to send a critical COVID-19 patient out of state. There were no ICU beds available in Nebraska at that time.
Even earlier in the pandemic, it was easier to get patients where they needed to go.
“The past month has been the worst it’s ever been since I started working here,” Wergin said.
The hospital tells KETV Investigates that some patients have had to wait more than five hours for a transfer. That may not sound like a lot, but that time could be life-altering. During that time, doctors, like Wergin, and nurses, like Starr, care for those patients, even without ventilators at their disposal.
“We have to just have somebody here to manually squeeze the bag, to have somebody breathe for the patient,” Wergin said.
When a patient has to be intubated, that means a staff member, one of the hospital’s most precious resources, has to be dedicated to breathing for them full time.
Wergin fears the worst could still lie ahead.
“It’s just a matter of time before we’re in a situation where we’ve got somebody hooked up to a bag, we’re doing this and maybe having to do that for hours, gosh I hope not days,” Wergin said.
For several weeks, Jefferson Community has had an average of three inpatients with COVID-19. That could pose a problem, because the hospital only has five negative pressure rooms, where patients with infectious diseases like COVID-19 can be isolated.
“Every time we’ve had to transfer a patient to an ICU or high level of care, we’re either having to wait for hours, or we’re having to wait for days,” Wergin said.
That struggle to find empty beds has doctors on edge.
“It’s very stressful,” Wergin said. “And you just wonder how much longer you can put up with that kind of strain?”
Not to mention the strain of combating misinformation, in a county where only 50 percent of the population is fully vaccinated, according to Centers for Disease Control and Prevention data. Starr said 80 to 85 percent of people hospitalized with COVID-19 at Jefferson Community are unvaccinated. The others are immunocompromised.
“I can’t think of an example off the top of my head of a fully vaccinated person that came in here so critical that we had to transfer,” Wergin said.
But the federal vaccine mandate makes Starr wary. More than 90 percent of Jefferson Community’s staff is vaccinated, but Starr fears hospitals are already short-staffed and can’t afford to hemorrhage more workers.
“To lose even 10 people would hurt us tremendously,” Starr said.
But Wergin hopes health care workers trust the science.
“Anything we can do to reduce the chances that we are going to spread, you know, deadly virus to someone else, we want to reduce the chances and the best way to do that is to get vaccinated,” Wergin said. “So I want everybody who works here to be vaccinated.”
As for the future, Wergin hopes rural America will see some relief.
“The scariest thing is, would be that if, once or twice a year, we’re having these big outbreaks of COVID throughout the state … where we’re in the position we’re in now where we can’t transfer people,” Wergin said.
With no easy cure for these struggles, a call for Nebraskans to stay vigilant, and get vaccinated.
“So that we can feel comfortable here in rural America that if we get somebody who’s really really sick, who needs to have a critical care doctor and an ICU right away, we can get them there right away,” Wergin said.