Months in a pandemic and now seeing an increase in COVID-19 cases, South Carolina hospitals were able to add fans, stock up on protective equipment and increase space if necessary. But the only finite resource they discovered cannot be expanded in the blink of an eye: People.
The lessons learned in March and April put hospitals in a better position to manage an increase in coronavirus cases. Reports of scarcity of supplies and space are now few and far between. The main concern now is that if Southern Carolinians continue to shy away from the guidance to wear masks and distance themselves socially, hospitals may not have enough staff to care for patients.
Across South Carolina, 1,404 patients were hospitalized with COVID-19 on Wednesday, just the last in a series of daily records.
State emergency planners said South Carolina could add 10,000 patient beds if needed, almost double the current capacity of hospitals. Finding nurses, doctors and technicians to care for these patients is a much more difficult problem.
Tidelands Health’s intensive care units were 96% full on Wednesday, the group at the Grand Strand hospital announced. The number of patients hospitalized with COVID-19 in Tidelands is 47 – close to 20 percent of all beds in the two hospitals in the system.
Gayle Resetar, chief operating officer at Tidelands, said recruitment has become the biggest challenge facing the healthcare system.
“It’s not that we don’t have enough beds,” she said.
Tidelands Health has brought in travel nurses, hired new people and is offering incentives to work overtime, said Resetar. South Carolina hospitals are competing with other states for temporary staff, some with equally attractive beaches and warm weather.
A nurse sees a COVID-19 patient on a ventilator at the intensive care unit at Trident Medical Center in North Charleston on Wednesday, July 8, 2020. Lauren Petracca / Staff
Pennie Peralta, vice president and director of nursing at Roper St. Francis Healthcare, said the Charleston nonprofit is also dealing with a labor shortage. But Roper St. Francis became creative, creating a group of employees from across the hospital system to examine patients at entrances and taking nurses out of administrative jobs to work directly with patients.
“This is the most agile we have ever been to,” said Peralta, who joined Roper St. Francis in 1978. She is confident that the people of Roper St. Francis can rise to the challenge.
Peralta said the system added a lot of fans and space. Fortunately, fewer patients need help from breathing machines now, partly because health experts have learned more about how to treat the disease and partly because hospitals are serving more young patients than before.
Roper St. Francis equipped new rooms for COVID-19 patients and expanded the capacity of beds. Worst-case plans require the use of classroom space, although this is not yet a necessity.
The health care system also began to worry about the illness of teammates. Considering the thousands of people they employ, hospitals can expect at least some of their employees to show positive results and require quarantine for 10 to 14 days. Resetar said the same thing about Tidelands.
Dr. Lee Biggs, medical director at North Charleston-based Trident Health, said the entire team was trained to work with COVID-19 in their related professions.
He said that Trident Health has the staff and resources needed to manage the growing population of COVID-19 patients. In the spring, the private hospital company developed the ability to triple the size of its ICUs. Patients who do not need intensive care can stay in a dedicated 40-bed unit. But even with additional space, the team remains the most difficult resource to grow.
“We can triple the size of the ICU,” Biggs said in an interview in late June. “I cannot create the team I need three times.”
The influx of coronavirus patients to hospitals comes after a difficult spring for the healthcare workforce. Most hospitals in South Carolina aggressively cut staff when they were forced to stop elective surgery and fewer patients came to their facilities. The number of employees in hospitals has not yet returned in full force.
Daniel West, a pharmacist, conducts hospital rounds out of COVID-19 patient rooms at the intensive care unit at Trident Medical Center in North Charleston on Wednesday, July 8, 2020. Lauren Petracca / Staff
During a board meeting in late June, South Carolina Medical University leaders said they rehired about half of the roughly 1,300 people who were laid off in early April. Initial plans called for employees to return in full force by July, the end of the fiscal year.
Spokeswoman Heather Woolwine said in a statement that MUSC is expanding its workforce to treat a greater number of patients with COVID-19. New hires were made and travel nurses were brought into the fold. The state-supported health system also cross-trained registered nurses to be ready to treat critical care patients.
Woolwine said the COVID-19 population within hospitals generally requires more staff to care for them. The disease also keeps people in the hospital for longer than average, undermining staff resources.
In Dillon County, one of McLeod Health’s seven Pee Dee hospitals reported that it is dangerously close to capacity, with 97 percent of available beds occupied on the Fourth of July holiday. That number has stabilized in the past few days.
Jumana Swindler, a spokeswoman for McLeod Health, did not respond to questions in the newspaper about whether the hospital brought in additional staff, but said that Pee Dee-based hospitals are prepared to deal with an increase in COVID-19 cases.
“We also have the ability to transfer patients to our other facilities, if necessary,” she said. “At McLeod Health, regardless of COVID-19, we adjust our team based on volumes and plan accordingly.”
Lorraine Larkin, an environmental services worker, mops the floor of a patient’s room at the cardiac unit at Trident Medical Center in North Charleston on Wednesday, July 8, 2020. Lauren Petracca / Staff
Catch up Mary Katherine Wildeman at 843-607-4312. Follow her on Twitter @mkwildeman.