As strain on hospitals reaches tipping point, leaders urge public to help reduce need for hospitalization
BISMARCK – Gov. Doug Burgum and chief medical officers and physicians from several of the state’s largest hospitals have warned that hospital capacity in North Dakota is reaching critical levels and urged the public to help reduce the need for hospitalization.
“The pressure on hospitals and clinics in both our urban and rural areas is reaching critical levels, and we all need to do our part to avoid hospitalization and prevent further strain on these facilities and their staff as we work through this incredibly challenging time,” Burgum said.
Hospitals ‘at redline capacity’
North Dakota hospitals and health systems have seen a significant increase in acute health care needs over the past several months, and they anticipate this higher demand to continue for some time, said Dr. Richard Vetter, chief medical officer at Essentia Health in Fargo. The additional demand has led to increased delays in access to care, particularly in emergency rooms and inpatient settings, Vetter said, noting patients are being referred outside of their usual referral patterns – sometimes to facilities several hundred miles away.
“We are concerned that as influenza numbers increase, this will also put additional strain on our health system,” Vetter said. “We strongly encourage everyone to consider receiving a flu shot in the next 1-2 months.”
Regional centers are currently unable to support critical access hospitals as they have in the past, and providers have seen adverse outcomes due to delays in care, said Dr. Chris Meeker, chief medical officer at Sanford Bismarck. Today North Dakota’s six largest hospitals reported 43 patients were deflected to other facilities, including six psychiatric patients; and 29 patients were waiting in emergency departments to be admitted to the hospital.
“Health systems across North Dakota face headwinds in caring for the people of our state. Our hospitals are at or above capacity, affecting care for all medical conditions. Physicians, nurses, and other vital frontline health care workers are doing heroic work caring for our communities despite shortages in staff and space,” Meeker said. “We have difficult times ahead, but I’m confident we’ll work together to see us through.”
Dr. Jeffrey Sather, chief of medical staff at Trinity Health in Minot, said the staffing shortage is the most daunting challenge facing hospitals.
“The health care systems in our state and across the region are at the point of being overwhelmed,” Sather said. “We are above our capacity to provide the normal care we all expect. I am so proud of every employee for what they go through every day. We have been doing the best we can over the past 18 months. I am also proud of the collaboration between health systems working together through this pandemic to care for our fellow citizens.”
“Now more than ever we need the help of everyone to reduce the strain on our health care systems by reducing the need for hospitalization,” Sather added.
Dr. Joshua Ranum, vice president of the North Dakota Medical Association and a physician at West River Health Services in Hettinger, said North Dakota was an early adopter of monoclonal antibody treatments that helped keep COVID-19 cases out of the hospital, but the current nationwide shortage of monoclonal antibodies is putting further strain on hospital capacity.
“Right now, stepping into a hospital in North Dakota is like stepping into an alternate reality,” Ranum said. “Our hospitals are at a redline capacity and will likely be that way for several more weeks. In stark contrast, one can move about the community almost normally, unaware of the chaos inside the hospital blocks away. We encourage all North Dakotans to get vaccinated, stay healthy, and stay safe in order to stay out of the hospital. It may be you or a loved one who desperately needs that hospital bed.”
How the public can help
The medical officials suggest several ways the public can help reduce hospitalizations:
- Avoid dangerous or high-risk activities that could cause serious injury.
- See your primary physician regularly and take care of your chronic health conditions.
- Make sure vaccinations are current for you and your children.
- Wash hands, social distance and wear a mask to help against all respiratory viruses.
- If you are sick with any respiratory virus, stay home and isolate to avoid infecting others.
- Practice defensive driving. There have been many recent high-trauma vehicle accidents in North Dakota. Obey traffic laws, use caution in construction zones, avoid distracted driving, use seat belts and helmets, and don’t drive under the influence of alcohol or drugs.
- Consider a telehealth option if you aren’t feeling well.
State fully engaged in response efforts
State leaders are working closely with hospital leaders to understand and support hospital capacity challenges.
Meetings are held daily with chief medical officers and chief nursing officers from the six large hospitals to review numbers of med/surg, pediatric and ICU patients, deflections, transfers, patients in the emergency department, nurses sidelined and monoclonal antibody usage. A weekly meeting is also held with the six large hospitals and the State Health Officer to discuss capacity issues.
The North Dakota Department of Health’s (NDDoH) Department Operations Center (DOC) has added four ambulances to assist hospitals with the growing number of patient transfers. As supply chains are tightening, the DOC has supported hospitals with blood tubes and testing supplies.
The DOC also manages the allocation and delivery of monoclonal antibodies to health care providers. In addition to the weekly federal allocation of monoclonal antibodies, the state has purchased 1,000 doses and is encouraging hospitals to do the same.
Currently, approximately 65 North Dakota National Guard members are on duty in support of the NDDoH to augment health care staff.
To address the staffing shortage in health care facilities, State Health Officer Dr. Nizar Wehbi has extended the waiver for temporary nurse aid registration in North Dakota through Dec. 31, 2021.
The NDDoH also continues to provide support for flu vaccinations and coordinate with long-term care facilities to make available more hospital capacity.