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Arissa Viering & Krista Allen | Goodday Mineral Wells | 11/9/2020 | Palo Pinto General Hospital Updates

PALO PINTO COUNTY, TX – On 11/9/2020, Amy Waller, MSN, RN-CENP, Chief Nursing Executive for Palo Pinto General Hospital, addressed the public via a press conference. Throughout recent weeks, Palo Pinto General Hospital has faced its struggles with the COVID-19 pandemic including difficulty with obtaining ventilators and facilitating transfers. In October 2020, 23% of tests performed by PPGH returned back positive. As of November, an increase of 4% is being seen with 27% of tests returning back positive. “What that said to us is that this is still very much active and alive within our community and we are beginning to see even more admissions in our hospital,” Waller stated.

Throughout the entirety of the press conference, one vital piece of the system in treating COVID-19 played a major role in the struggles recently seen at PPGH: Hospital Capacity.

Currently, PPGH has a COVID unit within the emergency department where patients suspected of or confirmed to have COVID-19 may be assigned. The hospital has a COVID area in the med-surg unit and six ICU beds that are all under negative pressure to prevent further spread as well. All patients who test positive for COVID-19 in need of inpatient treatment are assigned to these negative pressure beds in the ICU. The average stay for a patient with COVID is approximately five days. However, with the recent spike in positive cases, the hospital has had to overcome great challenges with ensuring enough beds are available.

“Today, four out of the six ICU beds are full. Last week, all beds were full,” Waller reports. In addition, twenty-one patients are also currently admitted for inpatient care, excluding obstetrics. As of today, the hospital is able to accept new patients:

“I would have some capacity to accept patients at this time. Again, things change on a 24-hour basis and it depends on how staffing is.”

Amy Waller, MSN, RN-CENP, Chief Nursing Executive for Palo Pinto General Hospital

What happens when Palo Pinto General Hospital meets full capacity? The answer is complex.

With med-surg numbers varying day-to-day and recent spikes in COVID positive cases, the hospital staff is handling the recent “uptick” with every resource possible, constantly analyzing their status day-by-day.

“We try to staff to Capacity,” Waller stated. “There was an issue obtaining ventilators two weeks ago. We owned five ventilators and our vents were all in use. We were fortunate enough to obtain a couple more from a colleague hospital and we are now renting an additional five ventilators,” Waller reported. With the previous five ventilators on hand, the two borrowed having been returned, and the additional five rented ventilators, PPGH now has ten ventilators in total. It is reported that the additional ventilators have not been used (including those borrowed). However, the hospital wanted to have them on hand just in case.

Having overcome the challenge of ventilators, the hospital faces two additional challenges in the road ahead: staffing and transfers. Sometimes, being transferred to a new facility can take 24 – 48 hours.

As of now, the hospital has obtained COVID convalescent plasma and Remdesivir to further treat higher acuity patients to prevent the need for transfer. Furthermore, the staff has a plan in place to allow for further nurses from management to provide clinical care should the hospital begin to reach capacity. This plan is known as its “surge-capacity” plan. In the case of a transfer, two problems can arise: a long holding period as the patient awaits admittance to a second facility and the possibility that all facilities within the surrounding metropolitan areas are at full capacity. However, with the staff and the new resources allocated to better treat higher acuity patients, PPGH remains confident in their ability to provide care:

“The staff has been managing this for seven months now and they actually have a great spirit.”

Amy Waller, MSN, RN-CENP, Chief Nursing Executive for Palo Pinto General Hospital

Although the annual staff party could not occur this year, the administration and management are constantly trying to find safe ways to celebrate their staff with treats and appreciation. PPGH management is addressing all the concerns of the staff to ensure their needs are met. Also, the staff is uplifting each other constantly. They lean on each other for support and even have their own private Facebook groups for support. 

What’s to blame for this most recent spike in COVID cases?

Waller describes concerns regarding the public still gathering without the use of masks. Furthermore, she has concerns for those patients that are waiting to seek care: “The biggest thing I would say is to encourage people to get tested. This virus is a chameleon. It may present as a common cold or a stomach bug . . . I would attribute the spike we saw to people being more active and out in the community.”

Waller states that she has seen patients come in recently with enterovirus as well. There is a concern for adenovirus, enterovirus, and Flu A/B at this time, especially as winter makes its entrance.

“If you’re sick, please stay at home, get tested, wash your hands, and wear your mask.”

Amy Waller, MSN, RN-CENP, Chief Nursing Executive for Palo Pinto General Hospital

With the need for continued testing, the hospital has finally received it’s new rapid-testing machine as of last week. The machine was ordered months ago, but due to demand, it took months to finally arrive. Currently, the hospital is performing correlation studies on the machine to prepare it for use. It is estimated that this rapid testing machine will be available next week. To obtain rapid testing, a patient must have a physician’s order. Currently, PPGH continues to have its COVID-19 hotline active and constantly staffed with well-trained nurse practitioners. Should these nurse practitioners feel it necessary for a patient to obtain testing, the patient can be sent to a mobile testing unit within Palo Pinto County. Outpatient physicians may also place an order as necessary for the patient to obtain rapid testing within the hospital. Point of care testing shall remain in place as deemed necessary by the ordering physician. Patients who are not displaying symptoms and who do not have a concern for having COVID, including those admitted for outside reasons, are not being tested for COVID-19.

As of now, the weekly COVID task force is continuing to meet once weekly. The county health official, Dr. Ed Evans has been keeping PPGH apprised of any current changes to the county case numbers.

“It’s going to be that capacity is our biggest concern as we continue to see the numbers increase.”

Amy Waller, MSN, RN-CENP, Chief Nursing Executive for Palo Pinto General Hospital

What can the community do?

It is suggested that COVID will continue to rise with more social gatherings from the upcoming holidays. The hospital is trying to educate the community to continue to wear masks, wash hands, and practice social distancing. If you feel sick, stay home. It has been said to expect a “rough winter” with all the other seasonal illnesses that come with the temperatures changing such as the Flu, etc. However, the most important take-away: Don’t delay care.

“We don’t want you to delay your care. It is so important that if you are having heart attack symptoms or stroke symptoms, that you come in. We are doing everything in our power to keep everything safe. I feel confident in the ability of us here at PPGH to provide care. Do not let the fear of COVID-19 be a reason not to be seen.”

Amy Waller, MSN, RN-CENP, Chief Nursing Executive for Palo Pinto General Hospital

To review the latest COVID data, click here.

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