{"id":42678,"date":"2022-01-17T17:29:00","date_gmt":"2022-01-18T00:29:00","guid":{"rendered":"https:\/\/dh.durangoherald.com\/tj\/mercy-icu-over-capacity-for-several-months-doctor-says\/"},"modified":"2026-03-31T03:08:40","modified_gmt":"2026-03-31T09:08:40","slug":"mercy-icu-over-capacity-for-several-months-doctor-says","status":"publish","type":"post","link":"https:\/\/dh.durangoherald.com\/tj\/mercy-icu-over-capacity-for-several-months-doctor-says\/","title":{"rendered":"Mercy ICU over capacity for several months, doctor says"},"content":{"rendered":"\n

\"Dr.
Dr. Gus Hallin, medical director of Mercy Hospital\u2019s intensive care unit, talks on Friday about the effects the coronavirus pandemic has had on the ICU and its staff. Mercy historically has averaged five patients in its ICU, but since July the unit has been overwhelmed with 16 to 20 patients on life support. (Jerry McBride\/Durango Herald)<\/span>cca<\/span><\/figcaption><\/figure>\n<\/p>

Mercy Hospital\u2019s intensive care unit has been overflowing with patients in recent months.<\/p>\n

Intensive care unit staff members at Mercy have been overworked and exhausted since July as they have been forced to expand their critical care unit to handle a crush of COVID-19 patients.<\/p>\n

The constant influx of the critically ill has strained staff, but amid the challenges they have faced, doctors, nurses and respiratory therapists have maintained their same standards of care, said Dr. Gus Hallin, medical director for Mercy Hospital\u2019s ICU, in an interview this week with The Durango Herald<\/em>.<\/p>\n

\u201cSince the delta (variant) surge really started to hit in July, we\u2019ve been extremely busy,\u201d he said. \u201cTwo years ago, our average ICU census at Mercy was about five patients. Since July, and especially in the last three months, we\u2019ve been between 16 and 20 patients on life support, so almost 400% of what we were in the past.\u201d<\/p>\n

Staff members were caring for 18 patients when Hallin finished his shift Wednesday morning.<\/p>\n

Neither Mercy Hospital nor Centura Health, the health care corporation that owns Mercy, responded to requests for comment.<\/p>\n

\"Dr.
Dr. Gus Hallin, medical director of Mercy Hospital\u2019s ICU, speaks about the strain that staff members have been under since July. Mercy Hospital was designed for a maximum of 10 ICU beds, but is now operating up to 20, he said. (Jerry McBride\/Durango Herald)<\/span>cca<\/span><\/figcaption><\/figure>\n<\/p>

The majority of patients are hospitalized with COVID-19, Hallin said.<\/p>\n

The ICU has also had its typical baseline of five non-COVID-19 critical patients throughout the duration of the pandemic.<\/p>\n

When Mercy Hospital first opened its 212,000 square-foot facility in June 2006, it was designed for a maximum of 10 ICU beds, Hallin said.<\/p>\n

The ICU was initially staffed for six beds, but has been permanently staffed for 10 since in March 2020, he said.<\/p>\n

\"Mercy
Mercy Hospital requested assistance from the state and federal governments to meet its staffing needs. Colorado\u2019s Staffing Shortage Fusion Center, which was reactivated by the state in September 2021 and coordinates short-term staffing requests from hospitals, sent 25 medical staff members to Mercy at the beginning of January. (Courtesy of Mercy Hospital)<\/span>Courtesy of Mercy Regional Medical Center<\/span><\/figcaption><\/figure>\n<\/p>

The pandemic has stretched that capacity, forcing the ICU to expand its operations to general care floors.<\/p>\n

\u201cWe\u2019ve converted a lot of our step-down units in the transitional care unit to ICU beds,\u201d Hallin said. \u201cNow there\u2019s generally between six and 10 ICU-level patients in our transitional care unit still staffed with ICU nurses and respiratory therapists.\u201d<\/p>\n

A step-down unit provides intermediate care for those patients with medical needs between the general ward and an intensive care unit.<\/p>\n

A transitional care unit offers short-term care for patients transitioning from the hospital to their homes.<\/p>\n

\"Mark
Mark Ritchey, a staff nurse in the ICU at Mercy Hospital, finishes checking on an unconscious and intubated COVID-19 patient in June. Dr. Gus Hallin, medical director of Mercy Hospital\u2019s ICU, said the overwhelming majority of critical patients have COVID-19 and are unvaccinated. (Jerry McBride\/Durango Herald file)<\/span>cca<\/span><\/figcaption><\/figure>\n<\/p>

Three to four respiratory therapists work during the day and another two to three care for patients at night in the ICU.<\/p>\n

Before the pandemic, the unit would staff three nurses during the day and three at night, but Mercy\u2019s ICU has added three to four additional nurses per shift to accommodate the additional patients.<\/p>\n

Nurses have turned to recruiting colleagues with critical care experience from the operating room and emergency departments at Mercy, and from outside traveling nurses to help shoulder the load of patients.<\/p>\n

Expanded staffing requirements have forced the nurses, who typically work 12- to 14-hour shifts three days a week, to add extra hours and days to ensure the ICU meets its staffing needs.<\/p>\n

\u201cI\u2019ve heard in the last few months a range of more like four to six shifts per week,\u201d Hallin said.<\/p>\n

Ideally, in an ICU, the nurse-to-patient ratio is one nurse per two patients to ensure the best care, he said.<\/p>\n

Mercy\u2019s staff has at times been stretched beyond that 1:2 ratio during emergencies.<\/p>\n

\u201cWe\u2019ve occasionally had to go up above that and watch them extra carefully,\u201d Hallin said.<\/p>\n

Inundated with patients, doctors, nurses and respiratory therapists have had to adapt.<\/p>\n

\"Vanessa
Vanessa Meisner, left, and Melanie Meador attend to a COVID-19 patient in the non-intensive care unit of Mercy Hospital\u2019s COVID-19 ward in November. Mercy Hospital\u2019s ICU has had to expand to general care floors to accommodate all of its patients. (Jerry McBride\/Durango Herald file)<\/span>cca<\/span><\/figcaption><\/figure>\n<\/p>

\u201cOver the last 20 months, we\u2019ve all developed a certain efficiency that we didn\u2019t have to have before,\u201d Hallin said. \u201cWhen we prone patients, (our staff) have gotten really good at doing that quickly and effectively with a team. We rarely had to do things like that. Now, it\u2019s almost a daily occurrence.<\/p>\n

\u201cOur nurses have been nothing short of heroic,\u201d he said. \u201cThey\u2019ve completely risen to the challenge these last few months and they\u2019ve really come together as a team.\u201d<\/p>\n

The adjustments Mercy staff members have made have not prevented fatigue.<\/p>\n

\u201cThe last two years have been a bit of a blur,\u201d Hallin said. \u201cI\u2019m so exhausted on my days off I\u2019m finally starting to recover when I go back to work and then it starts over again.<\/p>\n

\u201c(The pandemic) is hard to put in perspective,\u201d he said. \u201cI was a medical student at University of Illinois in Chicago and then a resident in Albuquerque in the late \u201980s and early \u201990s. I dealt with the AIDS crisis in those years. I was in Albuquerque in 1993 when we had the hantavirus crisis. I\u2019ve never seen anything like this.\u201d<\/p>\n

Mercy Hospital and Centura Health have requested assistance from the Federal Emergency Management Agency and the state in recent weeks, seeking both additional staff members and supplies.<\/p>\n

\"Vanessa
Vanessa Meisner, left, and Melanie Meador help a COVID-19 patient in November at Mercy Hospital\u2019s COVID-19 ward non-intensive care unit. Overflowing patients have forced the nurses, who typically work 12- to 14-hour shifts three days a week, to add extra hours and days to ensure that the ICU meets its staffing needs. (Jerry McBride\/Durango Herald file)<\/span>cca<\/span><\/figcaption><\/figure>\n<\/p>

Colorado\u2019s Staffing Shortage Fusion Center, which was reactivated by the state in September 2021 and coordinates short-term staffing requests from hospitals, sent 25 medical staff members to Mercy, a spokeswoman for the Colorado Department of Public Health and Environment told the Herald <\/em>in an email.<\/p>\n

The state sent the interim personnel to Mercy on Jan. 3 for orientation and began working on Jan. 5, the spokeswoman said. Hallin said he expects them to stay with Mercy until April.<\/p>\n

\u201cIt\u2019s been a real godsend. They\u2019re very enthusiastic and they\u2019ve been incredibly helpful so far,\u201d he said.<\/p>\n

Nurses sent by the state now fill three of the roughly seven nursing positions on each shift, covering about a third of critical patients.<\/p>\n

Yet, even as Mercy\u2019s ICU staff members find some relief, they are still facing the rapidly spreading omicron variant that has sent cases skyrocketing.<\/p>\n

San Juan Basin Public Health reported 314 new cases in La Plata County on Wednesday, a pandemic record.<\/p>\n

The omicron surge has only just begun to hit Mercy, Hallin said.<\/p>\n

The majority of the ICU\u2019s patients entered the hospital in late November and early December, meaning they were likely infected with the delta variant.<\/p>\n

\u201cProtecting health care becomes extraordinarily important as people are getting sick,\u201d said Liane Jollon, executive director of SJBPH. \u201cWhat we want from a public health perspective is to not have too many people sick at once so that health care cannot treat people and save lives.<\/p>\n

\u201cThe guidance that the state has put together is that 2,000 people hospitalized with COVID-19 (statewide) at once would be the point of no return for breaching our health care system,\u201d Jollon said. \u201cWe have approached that number. We approached it in December 2020, (when) we got to just under 1,900. In the delta wave, we got close to 1,600.\u201d<\/p>\n

\"Mercy
Mercy Hospital administered the first COVID-19 vaccination in La Plata County on Dec. 16, 2020. An 85% vaccination rate would stop the immense strain that\u2019s being placed on Mercy Hospital\u2019s ICU and its staff, said Dr. Gus Hallin, medical director of Mercy Hospital\u2019s ICU. (Jerry McBride\/Durango Herald file)<\/span>du1-i-syn<\/span><\/figcaption><\/figure>\n<\/p>

Hallin said the overwhelming majority of the patients in Mercy\u2019s crowded ICU are unvaccinated. Only vaccination and boosters will stop the immense strain that\u2019s being placed on the ICU and its staff, he said.<\/p>\n

\u201cThe data is gradually becoming clearer. At least 85% of the population has to be vaccinated against these newer variants, possibly even higher,\u201d he said.<\/p>\n

Though Mercy\u2019s ICU has been overflowing with patients, the team has maintained its quality of care.<\/p>\n

\u201cNot a single patient in the ICU has been let down to a lower standard,\u201d Hallin said. \u201cWe have maintained an extremely high standard (for) everybody, which has always been the Mercy way.<\/p>\n

\u201cWe had what I think is the best group of nurses and respiratory therapists in the state of Colorado going into this, so we were well prepared,\u201d he said. \u201cThe way they\u2019ve reacted to this is just awesome and I want the community to know that.\u201d<\/p>\n

ahannon@durangoherald.com<\/a><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

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