By Melissa Davlin, Idaho Reports
On Monday, Diana Rowe took her 82-year-old father, James, to the emergency room at North Canyon Medical Center in Gooding. He was dehydrated and weak, and a home health provider told Rowe to take him to the hospital right away.
When they arrived, the hospital was “jam-packed,” Rowe told Idaho Reports. Instead of putting James in a room, nurses ran tests on him in a decontamination shower room-turned-makeshift care space, Rowe said. Ultimately, they stabilized him and sent him home.
The situation Rowe and her father faced is increasingly common in hospitals small and large throughout the state, as health care facilities strain under the wave of COVID-19 patients — mostly unvaccinated — who need higher levels of care. That flood of COVID patients is affecting hospitals’ ability to care for others who aren’t COVID-positive.
On Tuesday, the Idaho Department of Health and Welfare announced that a crisis standards of care declaration for the Treasure Valley and south central Idaho is “imminent.” That designation was activated statewide on Wednesday, after a request from St. Luke’s Health System.
Crisis standards of care provides a framework for health care providers on how to allocate limited resources — such as staff members, beds, and medication — in extreme emergencies in which more patients need care than what hospitals can provide. Crisis standards of care have been in effect in north and north central Idaho since Sept. 6.
But even before the official declaration, hospitals already struggled to provide normal levels of care, leaving patients and family members like Rowe filling in the gaps.
“It’s awful today. He can barely get from point A to point B, and I am terrified,” Rowe wrote in a message to Idaho Reports on Tuesday. “I did get him to the doctor and they are adjusting his medications. We have another appointment with the specialist tomorrow.”
Rowe said she wishes he had been admitted for observation and given IV fluid, though she made it clear that the staff tried their best to care for her father.
“I am terrified with him only having me to know what’s going on. The hospital did give a prescription for antibiotics last night, but that’s it,” she said.
Requests for comment made to North Canyon Medical Center were not returned by Wednesday.
In north central Idaho, Rep. Caroline Troy, R-Genesee, faced a similar experience in early September while trying to get her 83-year-old mother, Ann Nilsson, help for an adverse reaction to antibiotics. Troy told Idaho Reports she took Nilsson to the emergency room at St. Joseph Regional Medical Center in Lewiston after Nilsson experienced swollen lips, a rash, and problems breathing.
After Nilsson tested negative for COVID-19, “the doctor said ‘I can’t admit her for a rash,’ and sent us back home,” Troy said, even though Nilsson had been admitted for similar reasons before, most recently in 2019. “In the past, they would have admitted her by this point.”
That was on a Friday night. Troy then tried calling skilled nursing facilities, but said none would take Nilsson unless she had spent three consecutive nights admitted at the hospital. Over the weekend, meanwhile, the rash had turned into painful blisters that covered nearly 20 percent of Nilsson’s body, Troy said.
The following Tuesday, doctors made the decision to lifeflight her to a burn center in Seattle, the nearest facility that could treat her skin lesions.
Nilsson has since been discharged, but Troy had to arrange an ambulance service to bring her back home to Idaho. The cost: more than $9,000, half of which had to be paid upfront.
In a statement to Idaho Reports, Samantha Skinner, communications officer for St. Joseph Regional Medical Center, said though St. Joseph is in Public Health District 2, the facility isn’t operating under crisis standards of care at the time.
“This doesn’t mean that COVID-19 is not significantly impacting our hospital,” Skinner wrote. “In fact, our current COVID-19 situation is worse than it has ever been. Again this week, we are seeing an increase in the number of patients being treated for COVID-19 in our hospital, and we are currently treating nearly 20 patients, the highest number of COVID-19 positive patients we’ve experienced at any previous point during the pandemic.”
Skinner didn’t answer whether the hospital is able to admit every patient who needs higher levels of care, or if some are being sent home or discharged early who otherwise might be admitted for observation. She did say, however, that St. Joseph is pausing non-urgent medical procedures that require inpatient stays until further notice.
“Even in the midst of this public health emergency, we strongly urge our community not to delay essential and emergency care,” Skinner wrote. “You may experience longer wait times, but you will be seen.”
Further north at Bonner General Health in Sandpoint, Dr. Stacey Good told Idaho Reports the critical access hospital is having difficulty managing patients who need specialty care, such as dialysis. In normal times, Bonner can transfer patients to Kootenai Health in Coeur d’Alene or Sacred Heart in Spokane.
Both are currently full, leaving staff members to call other facilities and hope someone can take their patient.
“It is a long process. We’ve called up to six states, and 30 to 40 hospitals to try to find a bed for patients,” Good told Idaho Reports. “They’ve gone as far as Wyoming.”
Everyone does get care, Good said, but it takes time.
“What ends up happening is we put them on waitlists everywhere. Eventually they get a bed. Eventually they get a call,” Good said. But that takes time. And because of the wait, Good said, some patients have experienced adverse outcomes, including death, that could have otherwise been prevented had they been treated sooner.
Troy said she was just grateful she was able to figure out how to care for her mother, who is currently in an advanced care facility in Lewiston.
“I don’t know how these people do it (if) they don’t have a family member who is able to advocate for them,” Troy said.
But sometimes, advocacy isn’t enough. On Wednesday, Rowe was still trying to figure out how to help her father. A doctor had fit him with a catheter so he wouldn’t fall while going to the bathroom, but Rowe said he needs more help.
“He’s so weak, I needed help getting him into the car, had to get a wheelchair to get him into the doctors,” she wrote in a message to Idaho Reports. “I’m still terrified about taking care of him without the resources I need. I wish he could be admitted to get his health back stable.”