The hospital announced it may soon implement “crisis standards of care,” which basically means it will ration its equipment, staff and medicine, giving preference to those it can most likely save, regardless of vaccination status.
“The problem is,” said Brad Von Bergen, the hospital’s ER manager, “we are running out of hallways.” The hospital’s intensive care unit has been over capacity amid a deadly surge. Jaimee Belsky show a hallway at Billings Clinic that has been converted into several small patient rooms. Billings Clinic emergency department manager Brad Von Bergen and Dr. Hospital staffers volunteer to sit with dying patients. Ten members of the Montana Army National Guard arrived last week to help however they can. In the lobby of the emergency department, rooms roughly 6 feet by 6 feet have been fashioned with makeshift plastic walls. To handle the overflow, nurses elsewhere provide care beyond their training as COVID patients fill other parts of the hospital. The ICU here has space for 28 patients but last Friday was operating at 160% capacity, Baxter said. Now, tensions are so strained that Billings Clinic is printing signs for its hallways, asking that the staff members not be mistreated. Not so long ago, the cheers of community support could be heard from the hospital parking lot. What’s different from the early scenes of the pandemic is the public’s response. Last week, the county had 2,329 active cases, more than the next two counties combined. The state announced 1,209 new cases on Friday, and Yellowstone County, home to Billings Clinic, is seeing the worst of it. But now Montana is a national hot spot for COVID infections, recording the highest percentage increase in new cases over the past seven days. The situation has played out in hospitals around the nation since 2020. “I do feel a little hopeless,” said Christy Baxter, the hospital’s director of critical care. Nathan Allen, medical ethicist for Billings Clinic and department chair for emergency medicine “We are at the point where we are not confident going forward that we can continue to meet all patients’ needs.
In the past week, 14 people have died of COVID here, the state’s largest hospital. The hospital’s morgue cart arrived at the ICU - as it frequently has these days - then the room was sterilized, another patient took the man’s place, and the cycle began again. He was dead, at age 24, by Sunday morning. Visitors generally aren’t permitted in these rooms, but the man’s mother comes most days to gaze through a glass window for the allowed 15 minutes. They have COVID-19 - the vast majority unvaccinated against the virus, the hospital says. He is among other patients, room after room of them, with the same grim tubes inserted down their throats. The man has been a patient at Billings Clinic for nearly a month, most of that time in the hospital’s intensive care unit. The dark lesions are insignificant given his current state, but she continues just the same, gently, soothingly, appearing to whisper to him as she works. Lying on his stomach all those hours has produced sores on his face, and one nurse dabs at the wounds. This story also appeared in Kaiser Health News
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