Racing to add extra ICU beds as COVID-19 patient surge tests hospitals, providers

Dec. 6, 2020
Facilities workers at UCHealth Memorial Hospital prepare for more COVID-19 patients.
Facilities workers at UCHealth Memorial Hospital Central remove windows in the building to provide enhanced ventilation in rooms needed for a projected surge in COVID-19 patients. Photo: Cary Vogrin, UCHealth.

It’s a crisp December morning when a semi-truck backs up to a loading dock at UCHealth Memorial Hospital Central in Colorado Springs.

The back doors of the truck swing open. Inside, a dozen ICU hospital beds wrapped in plastic are ready to be unloaded. Later that day, two more trucks are coming, bringing a total of 30 beds with jelly-like mattresses to provide optimal care and comfort for patients.

Across UCHealth, extraordinary preparation has been underway to care for a surge of COVID-19 patients, and anyone else who has a serious medical issue. UCHealth has about 411 people hospitalized, up significantly from the peak of 263 patients in the spring. Based on prediction models, the number of people currently hospitalized could double in the coming weeks.

“We are on the brink of a controlled crisis,” said Cathy Ehrenfeucht, vice president of operations and capacity at UCHealth University of Colorado Hospital.

At Memorial Hospital Central, the flurry of activity on the dock – delivery of more beds, equipment and supplies – is a fraction of a herculean effort underway. Nothing says these are not normal times quite like the view from the east side of Memorial, where windows have been removed in patient rooms to quickly convert them into rooms for more COVID-19 patients.

“What our facilities crews have done is they’ve removed the smaller windows,’’ says Merle Taylor, chief operating officer at Memorial. “In order to ensure safe airflow in rooms where COVID-19 positive patients are being cared for, we removed windows and added a machine that filters the air and removes it through the new openings. This helps to increase air recycling, keeping the room at negative air pressure, which minimizes exposure to staff and visitors.”

 

Additional beds need to accomodate a surge in COVID-19 patients are in a warehouse at Memorial Hospital Central.
Beds for ICU patients are in a warehouse at Memorial Hospital Central. The beds will be cleaned, examined by clinical engineers and moved to patient rooms to accommodate a projected surge in COVID-19 patients. Photo: Cary Vogrin, UCHealth.

All of this effort is aimed to meet a projected surge in patients.

“We want to make sure that we’re meeting the needs of every individual and our community, not only in Colorado Springs but across Colorado,’’ Taylor said.

Planning for what Dr. Anthony Fauci, the nation’s leading infectious disease doctor, calls a “surge upon a surge,’’ has been ongoing since March at UCHealth. And for the most part, that planning is about math.

Larry Tremel is Memorial Hospital’s pharmacy director, but these days he doubles as a logistics chief, assessing every need. He knows that for each additional bed needed, there’s a cascade of more needs: pumps, IV poles, monitors, food, cleaning supplies and more. And, of course, frontline caregivers: doctors, nurses, care techs, environmental services personnel, to name a few.

“We assess our need for everything from toilet paper to Remdesivir,’’ the anti-viral drug given to COVID-19 patients, Tremel said.

Asked whether, in his 36-year career, he’s seen such an effort, he answers succinctly: “Never.’’

Is there anything to compare it to?

“Nothing.’’

Beyond COVID-19, UCHealth hospitals are still caring for many other patients, too. Patients arrive every day with broken bones or allergic reactions. Some surgeries and non-life threatening procedures are being rescheduled, though anyone in an emergency situation, or having a cardiac, neurologic, trauma, orthopedic or oncology emergency – as always – is a priority.

“Members of our community need care and we will make sure we are here to provide it safely,” Ehrenfeucht said.

UCHealth hospitals have redeployed many clinicians to the front lines. Nurses who may have worked in a non-clinical role, or in outpatient clinics, are receiving just-in-time training as they are deployed to the bedside working as a team partner with inpatient nurses. Employees who work in non-clinical jobs are supporting the deployment of staff, equipment and supplies, perhaps serving in roles they haven’t served in before, to support those on the front line.

Patti Loper, a registered nurse for 23 years, has switched from her usual job as a clinical quality care specialist, a desk job at Memorial focused on maintaining quality care, to units throughout the hospital, including the COVID-19 ICU. She is among dozens of nurses at Memorial who are part of the “Helping Hands’’ program, an “all hands on deck’’ effort to support inpatient RNs.

“It’s been a whirlwind. We coordinated pretty quickly,’’ Loper said. “They asked us to help and we jumped in. They asked what areas we felt comfortable working in, and I am an ED nurse by training, so I asked for ED, critical care and acute care areas.’’

A photo of Patti Loper in a mask at UCHealth Memorial Hospital Central, who has moved from a desk to patient care to help with the increase in COVID-19 patients.
Patti Loper, a registered nurse who usually works a desk job aimed at maintaining high-quality care, has been deployed to patient care units to help with patient care as the hospital sees more COVID-19 patients than ever before. Photo: Cary Vogrin, UCHealth.

Even for a seasoned nurse, the sight of so many patients intubated and on ventilators, all with a significant need for oxygen, was jolting.

“It shook me,’’ Loper said. “They are very sick patients. They are some of the sickest patients I’ve seen in my career. Another thing that shook me a little bit, we have patients in their 30s; patients in their 50s and elderly patients.

“I commented to the other nurses about the younger people, and they said, ‘Yep, COVID doesn’t care. It doesn’t discriminate.’ ’’

During another shift on a medical floor where patients were not intubated and able to speak, some apologized to her for needing care.

“Patients are concerned that they are putting us at risk, and it is really sweet. But I told each one, ‘You know what? We’re going to take care of you, regardless. This is what we do.’’’

People like Loper are everywhere at UCHealth, willing to step up for what surely will be the most remarkable period of their careers. It is an iron-clad dedication to duty – and humans in need – that bolsters them.

“We’re the last stop for so many people,’’ Taylor says. “In this region, we’re the Level I Trauma Center and so many hospitals rely on us. We’re it. And we have to be the ones. We have open arms.

“And while we’re all a little tired, we keep doing it because we know that if we don’t do it, nobody else is going to be able to do it for them.’’

At a time when many people are struggling emotionally and financially, the health and well-being of those heroes on the front line has never been more important. To show gratitude, UCHealth is providing free meals to employees during the height of this surge. Thank-you notes are posted in hallways. The internal website shares heartfelt notes of gratitude from some of the more than 4,000 people who have been well enough to leave the hospitals since March after treatment for COVID-19.

At Memorial, crews are planning an employee respite room – a darkened space with soothing music, essential oils and a waterfall feature to give frontline employees, a resilient bunch, the chance to take a breath.

“What we’re learning, actually, is that there is some revitalization,’’ Taylor said. “What a lot of people are saying is: ‘This is why I actually got into nursing. I’m doing more, I’m coming back to my calling. We have a lot of nurses expressing that.’’

Derek Susa, an associate clinical engineer, moves ICU beds to ready it for more COVID-19 patients.
Derek Susa, an associate clinical engineer at UCHealth Memorial Hospital, moves an ICU bed to a warehouse, where it will be cleaned and examined before being sent to a room for the surge of COVID-19 patients. Photo: Cary Vogrin, UCHealth.

At University of Colorado Hospital, Ehrenfeucht, known for an incredibly positive outlook, pandemic or not, loves to ask for collective ‘whoop whoops’ when a project is completed. There are plenty of them these days. She ends meetings by having staff share wins. So many times, the ‘whoop whoops’ come because a patient has come off of a ventilator, or become well enough to leave the hospital.

Taylor recalls lining the hallway with other colleagues last spring, when a survivor of COVID-19, a woman who had been in the hospital for four weeks, was being wheeled out of Memorial.

“I remember what she said when she was being wheeled out. She said, ‘I didn’t think I was ever going to get out of here. And I can see my sister again.’ And her sister was waiting at the end of the ramp.‘’

“That’s really meaningful for us,’’ Taylor said. “That touched a lot of us.’’

Taylor said that one of the reasons he works so hard is because the mission at UCHealth resonates with him. It’s simple: “Improve lives.’’

“If we’re opening our capacity so that we can take care of more people, and if we’re opening our capacity so we can be a referral center for all of our hospitals in the region who don’t have the resources to do it, then we are improving people’s lives,’’ Taylor said.

The next few weeks, more people than ever are expected in hospitals across the state.

At UCHealth, more trucks will be pulling up the docks to unload supplies. More beds, medications and food will come. The facilities team may need to remove a few more windows.

“Whatever it takes to take care of anyone in a bed, that’s what will happen,’’ Taylor said.

UCHealth Today writer Molly Blake contributed to this story.

About the author

Erin Emery is editor of UCHealth Today, a hub for medical news, inspiring patient stories and tips for healthy living. Erin spent years as a reporter for The Denver Post, Colorado Springs Gazette and Colorado Springs Sun. She was part of a team of Denver Post reporters who won the 2000 Pulitzer Prize for breaking news reporting.

Erin joined UCHealth in 2008, and she is awed by the strength of patients and their stories.

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