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ER doctor shares struggles during COVID

After almost two years of dealing with the impact of COVID-19 pandemic, emergency room staff are feeling the toll.

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Dr. Patten
Contributed / Sanford Health

Dr. Andrea Patten has been practicing medicine for nine years, the past two and a half as an emergency physician at Sanford in Bemidji.

“It’s been a long haul, and I don’t think any of us anticipated that it would continue this long, that we’d still be having new waves of the virus coming through,” she said. “Everyone is tired, but hanging in there. When the vaccine first came out there seemed to be light at the end of the tunnel. Then delta was a low blow. Now it feels like omicron is kicking you when you’re down. It’s here and rapidly spreading across northern Minnesota full force. During one shift recently, I had seven people in a row who were COVID positive.”

Seeing the impact of COVID on other patients in the ER has also been hard.

“Never in my career would I imagine that someone could have a critical blood clot that requires specialty care or they will lose their leg and now we’re coming to a point in medicine where those patients come to the hospital in Bemidji, where we don’t have the services to help them, and we can’t send those patients anywhere,” she said.

“At times, there aren’t any hospital beds. That’s what a lot of people don’t understand. You or your loved one may not be able to get the care you need to save your leg or your life because of everything related to the pandemic, whether it’s hospitalized patients or staff shortages. That feels really heartbreaking as an ER physician. You could fly them somewhere, but there is no place to care for them.”

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Patten said she has had patients die from COVID.

“Patients who come by ambulance from home and you think you have stabilized in the emergency department, and they get worse and have respiratory arrest and die. We get called to the ICU for codes in Bemidji and they are often patients you admitted in the ER, so you recognize their names because you admitted them three or four days ago with COVID and now they’re dying. It’s really a different time in medicine with a lot of heartaches for families and staff. I have colleagues who I’m close with who are even in worse scenarios than we are in Minnesota. They are having patients dying in the ER on a regular basis because they didn’t have enough equipment for them or couldn’t support them through their illness.”

Omicron’s impact

The recent surge in the omicron variant is also affecting staffing.

“We are having quite a few staff members out, including some who are fully vaccinated,” Patten said. “Staff who are tired from the pandemic going on these past two years are now having to work longer and harder. We’ve also had lots of nurses and support staff out. You can’t move patients through, you can’t get rooms cleaned. The kitchen hours are reduced because there’s not enough staff. It impacts patient care and morale at the hospital.”

She said wait times in the ER are variable.

“We have tried really hard to combat our increased ER volumes,” she said. “We’ve added a provider who sees patients in our pre-op era during really busy times, like evenings and weekends.”

In spite of these measures, sometimes patients need to wait longer to be seen or to be moved to the hospital.

“We are reaching the point where some hospitals in the area are full and you can’t transfer patients,” she said. “When patients admitted to the ER can’t go anywhere, it creates a backlog. Sometimes beds are available, but there aren’t staff to take care of them.”

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Some traveling nurses and doctors have filled in at times, and five members of the National Guard are planning to come to help with staffing shortages in the next month.

Existing Sanford staff have also received training to fill in high-need areas, like the ICU, ER and COVID units.

How patients can help

“One of the most frustrating things that I encounter every single shift is people who know they have COVID, but don’t wear a mask or get frustrated when you ask them to put the mask over both their nose and mouth,” she said. “That is one of the lines of defense to keep from infecting other patients and hospital staff and their families. Putting a mask over your nose and mouth can help save someone else’s life. It’s so simple and so important.

“When I walk into a room, it seems like such a pointed sign of disregard when a patient won’t put a mask on or pull it up when you ask them. I wear two masks, a surgical mask and an N-95, for 10 hours straight and it’s not a problem with breathing through them.”

Patten said patients can also help by trying to manage symptoms at home when possible, calling their primary care provider, doing an e-visit or making an appointment to be seen at the clinic, as well as getting tested for COVID at walk-in-clinics or other testing sites rather than going to the emergency room for testing, would also help their patient load. Sanford also has a nurse line and a COVID line that patients can call to get information about when they need to go to the ER.

“Anyone with difficulty breathing, low on oxygen and in respiratory distress, anything they feel is an emergency, that’s who the emergency room is there for,” she said. “Those who are just not feeling well but not in distress, those patients don’t need to come to the ER. People get triaged at walk-in and if needed sent to the ER.”

Pushing through

“Everyone in health care is really trying, even though we’re tired and feel the burden of this pandemic,” Patten said. “We’re still showing up and trying to take really good care of patients. That’s what we signed up for when we chose this career. Getting care might not be as fast as someone had hoped and wait times may be longer, no doubt.

“We take people back based on their level of acuity or how sick they are, not when they showed up. So if you are observing other people going in front of you, that's a really good sign for your health, even though it’s frustrating.”

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Patten said she doesn’t know how to convince more people to get vaccinated.

“Maybe some people will be motivated by the $200 incentive for getting kids 5-11 vaccinated, I don’t know,” she said. “Potentially, what could get people motivated is if people can’t do what they want to do without being vaccinated, like get on an airplane or go out to dinner, but that would take some big policy changes.”

Related Topics: SANFORD HEALTH
Lorie Skarpness has lived in the Park Rapids area since 1997 and has been writing for the Park Rapids Enterprise since 2017. She enjoys writing features about the people and wildlife who call the north woods home.
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