Earlier this month doctors and nurses at Sky Lakes Medical Center in Klamath Falls invited Klamath County commissioners to meet with them about the community’s response to the pandemic.
The meeting was planned after Klamath County commissioners criticized some of the governor’s restrictions on businesses in November as COVID-19 infections skyrocketed across the state.
The commissioners characterized the governor’s restrictions as too harsh for small rural communities.
Dr. Grant Niskanen, vice president of medical affairs for the hospital, said Sky Lakes staff wanted to give commissioners personal insight into how COVID-19 was impacting the hospital.
They also wanted to share their frustrations about how the virus had become a politically divisive issue in Klamath Falls and across the country.
The belief that not wearing a mask or adhering to social gathering restrictions is an expression of personal freedom is common in Klamath Falls, Niskanen said.
“Yeah, it may be infringing on your freedom, but there are a lot of things we do for other people’s safety, such as following the speed limit, not running stop signs or street red lights,” Niskanen said. “We do those to protect other people, we need to start doing that in this community or we’re going to be in dire straits.”
As local infections skyrocket and patients get sicker and stay longer, staff in the isolated rural hospital fear for their ability to provide essential care.
Niskanen said there is currently one nurse for every four critically ill patients in the hospital. Normally, that ratio would be one nurse for every two patients.
“We have bed space, but we don’t have nursing staff,” Niskanen said.
Niskanen said the hospital is so full that they are trying to transfer patients to other facilities.
Dr. Holly Montjoy, co-chair of the hospital’s inpatient COVID-19 response team, said that transferring patients is hard because Klamath Falls is extremely isolated. The town is at least 70 miles from a larger facility and hundreds of miles from tertiary care.
“We’re in a very dire and critical situation right now,” Montjoy said.
Montjoy said that higher nurse to patient ratios make it harder for staff to give essential care.
“The death rate, unfortunately, goes up the more stressed the staff are because you can’t give close personal attention to each of the patients,” Montjoy said.
The hospital has doubled staff pay, but even with the increase, Montjoy said Klamath Falls’ isolation makes recruiting and retaining new staff difficult.
Multiple providers and staff members are also testing positive for coronavirus every day. This means more staff have to quarantine and be tested, which puts even greater stress on staffing levels.
It also leaves fewer ICU beds available for people dealing with non-COVID emergencies like heart attacks or car accidents.
“We would do everything possible in our power treat that, but we’d also be looking to transfer to a place that may have more capacity than we have at this time,” Niskanen said.
Montjoy said significantly more people are also coming into the emergency room with COVID-19 symptoms. She said one Sky Lakes physician reported that early on in the pandemic, he saw two to three ER patients in the course of a shift. A few weeks ago, that same doctor saw 23 COVID-19 patients in one ER shift.
Now that COVID-19 ER admissions are so common, the hospital is sending some people home directly from the department with oxygen and a pulse oximeter to measure their oxygen levels at home. Prior to the pandemic, oxygen would only be given in an inpatient setting.
At the meeting with Klamath County commissioners Montjoy told them: “We’re not here to ask you to take a stand for the governor or for any other politician. We really just want you to take a stand for us. We really are not talking politics.”
Though rates of coronavirus infections across Oregon have slightly declined in the past few weeks, infections in Klamath Falls are still increasing.
Niskanen hopes his community can pull together to stop the spread.
“I appreciate all the sacrifices people are making, but we need to hang in there a bit longer.”
To hear more from Think Out Loud’s conversation with rural doctors, press the “play” button at the top of the page.
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