“Part One: The Beds” begins a series in the intensive care unit, emergency room and inpatient facilities at SSM Health’s Monroe Hospital in which staff say they are in a crisis unlike any other point in the pandemic
MONROE, Wisconsin – The intensive care unit at SSM Health Hospital in Monroe is silent. There is a calm, steady energy as nurses move, huddled at the central desk or curtains closed behind them, as they graciously shield a patient from the camera lens and public gaze.
Behind these curtains the silence hides the reality.
The hospital serves rural communities in southern Wisconsin and northern Illinois and has only six intensive care beds. When a News 3 Now team spent nearly four hours in the hospital on Wednesday, all six were filled with COVID patients.
“Very rarely do we see a vaccinated patient,” recalls Janelle Jaeggi, nurse in the intensive care unit and coordinator of the weekend shift. She has been in this intensive care unit for fourteen years, and at no point has it been worse. “If they survive, they have a very long way to go.”
You will be there days – weeks – maybe longer. The lucky ones who make it out of the intensive care unit will have weeks and months ahead of them and lead newer, harder lives. Patients may have to spend more weeks in a lower bed or wait for a long term care room to open.
“Their bodies are very deconditioned,” said Jaeggi. “You’ve been in bed for weeks, if not months. They are fed through a feeding tube. You breathe through a hole in your throat. “
Her eyes are tired while she speaks.
“This is 100% real. It’s not a fake, ”she says emphatically. “They are patients in their 20s, 30s, 40s, and 50s. It is not only patients who have chronic underlying diseases. They are patients who come with no medical history. I mean, it affects everyone. “
The intensive care unit has been in this state for months. Nurses from other departments help where they can. When there’s a shortage of patients in need of critical care, it can take 20 or 30 calls – or a sophisticated relocation arrangement – to find another facility to accommodate them. And for Jaeggi and her colleagues it takes its toll.
“It’s been a lot lately,” she said. “If you can, please get vaccinated.”
Hospitals are grappling with bed shortages across Wisconsin
Nationwide, the Wisconsin Hospital Association reports that COVID hospital admissions have risen sharply in recent months. It is by far the highest value in 2021; the number is rapidly climbing to the level of hospital admissions briefly hit last December.
The Ministry of Health released data this week showing that unvaccinated people are 12 times more likely to die from COVID than those who received a vaccine. The probability of infection for unvaccinated people was three times as high; a vaccinated person was much less likely to die or be hospitalized than those who had not received the vaccination.
In Wisconsin, nearly 10,000 have died of COVID since the pandemic began.
Jaeggi becomes silent when asked what patients say when they reach a crisis point in the intensive care unit.
“Many of them know that once they are on a ventilator, their chances of survival are slim,” she said. “Before going on a ventilator, some just say, ‘I wish I had my injection.'” Others, she says, have no regrets.
At no point in the pandemic did Monroe Hospital suffer such a surge, President Jane Curran-Meuli said. While larger hospitals have had frequent occupancy rates over the past 20 months, smaller hospitals like yours have still had the option of sending their critical or overcrowded patients to other facilities for care.
RELATED: SSM Health Suspends “Non-urgent Medical Procedures” at Monroe Hospital due to an increase in patient volume
Now those calls are coming the other way as they battle their own first surge in the pandemic.
“We probably take six to ten calls a day from other hospitals who want to move to us,” she said. Rarely can they take the transfers in the midst of their own dozen of calls.
“We worked with our hospitals to do almost a three-way deal: this patient needs this level of care, so we’re going to move him, but to do that we have to move this person here and we’re ‘going to take this patient away from you.”
While COVID is driving much of the surge, non-COVID patients are also getting sicker, Curran-Meuli said. In combination with COVID stays, which tend to extend much longer than the average, an average hospital stay is up to 14 days from 3 days before the pandemic. People are delaying care – and the results, she says, are fatal.
“I’ve seen patients in whom we would normally have contracted lung cancer – they appear for the first time in end-stage lung cancer,” said Curran-Meuli.
Patients wait hours, days in the emergency room for beds to be opened
Three floors down from the intensive care unit in the emergency room, two non-COVID patients were waiting for hospital beds on Wednesday morning. That wait could be 36 to 48 hours, said EMS coordinator RN Mary Tessendorf, at which point almost half of her inpatient beds were filled with COVID patients.
“We bring down a hospital bed from the penthouse and make it as comfortable as possible for you,” explains Tessendorf. The two patients waited on standard inpatient beds; If it were a crisis and an intensive care bed was needed, the situation would be very different.
“We’d have to wait for a bed to open in the intensive care unit, and that could take days,” she noted.
Then sometimes the hospital has to rely on creative or sophisticated transfer solutions, or simply on manpower, as doctors make dozens of calls to transfer their patients across the country.
In addition to the intensive care unit, coordinating beds in the inpatient facilities of the hospital, the family birth and the intensive care unit are part of Jaeggi’s work on the weekends. When there is a crisis, such as a car accident, where multiple patients may need high-level care, the burden only increases.
“When the intensive care unit is full of patients, you take someone seriously ill to the emergency room and we try our best to get them out,” she said. But when the beds aren’t there – which is often not the case – she spends hours herself in the emergency room trying to keep the patient in the ICU cared for while she goes about her other duties.
That was the case when a patient was recently admitted without a heartbeat. They resuscitated him, but he needed a level of critical care that the emergency room staff are not trained for. Jaeggi spent several hours in the intensive care unit that day, administering IVs and IVs, and monitoring his blood pressure while doctors across the state searched for a bed.
Laurel Taylor has worked in the hospital for nearly 41 years and in the emergency room since 2007. She has never before experienced such an inability to move patients or get their beds.
“Optimal care was difficult,” she explained. “Sometimes it takes 20 or 30 calls to get a patient where they’re needed.”
The days in the emergency room are taking their toll right now, she said. And some in the community don’t seem to get it.
“Some people are a little shocked. They ask: “Is this really the case? In Monroe? ‘ Yes. It really happens here in Monroe. What you hear on the news is true. “
“This is nothing like flu season”
On the upper floor, the 55-bed hospital has around 40 inpatient beds in two wings. The 19 beds in a wing are exclusively dedicated to COVID patients. Only one was open when we visited and was expected to be filled later that day.
“We have had patients who have been here for two months,” said Jeanette Williams. As an inpatient nurse and administrative manager, she has been working in the hospital for six years since graduating from school.
“It’s nothing like a flu season,” she said. “Absolutely nothing like that. We’re trying to stay afloat here somehow. “
The good days are when someone goes home, not to another facility. Often times, after weeks or months, caregivers have bonded with their patients, and it is a celebration for caregivers and patients alike when they make a success story. But feelings of defeat also arise far too often.
“We have patients who are not doing well, or patients who are only here so long and take one step forward and two steps back every day.”
It’s hard not to think about her when a nurse comes home for the day, said Jaeggi, wondering whether they were doing better or if they were bad. And when a patient gets worse or dies, it’s hard to remember not to blame yourself.
“You think to yourself, ‘What am I doing wrong? Could I have fixed that? How could I have prevented that? ‘”
We all ask: what is your message to the public? For many, vaccination, masking, taking precautions. It is about the common good, explained Curran-Meuli. It’s about trusting your doctor and avoiding untested information from the internet or untrained people, Taylor added.
It is a desperation for everyone to convey the daily reality of what they see in the workplace: the shortage, the suffering, the deaths.
“That is real.”
Photojournalist Brian Mesmer contributed to this report.
This is Part One: The Beds in a multi-part series at Monroe Hospital. On Sunday at 10 am, “Part 2: The staff” will deal with the shortage of staff, another facet behind the nationwide hospital crisis.
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