Tucson Medical Center is dealing with staffing and capacity issues in its COVID intensive care unit.

 Angela Pittenger / Tucson Medical Center

Tucson’s medical professionals know better how to treat COVID-19 patients now, but hospital leaders are worried about having enough workers to handle the latest coronavirus surge here.

Banner Health and TMC HealthCare are both recruiting help, but so are many hospitals nationwide as the need for more staffing continues to grow.

β€œIt is challenging this time around because right now, every state is a hot spot, whereas in the spring different states were hot spots at different times,” said Judy Rich, president and CEO of TMC HealthCare, the parent company for Tucson Medical Center, 5301 E. Grant Road.

β€œWe are seeing numbers as high as we did in July,” Rich said, β€œand facing staffing and capacity issues in our COVID ICU.”

Hospitals here are already taking in arrivals from overwhelmed facilities in Texas and New Mexico, and are also using the state’s surge line as needed to move patients around within the state.

Northwest Medical Center and Oro Valley Hospital got help from other areas of the country over the summer, but are finding help is now more limited, said Jennifer Schomburg, chief executive officer for Northwest Healthcare.

They still have some traveling nurses in their hospitals, she said, and they’d welcome more.

β€œOver the summer, we received a disaster medical assistance team from the (U.S.) Department of Health and Human Services,” she said, β€œand have made a request for another team.”

Many states are competing for the same pool of nurses, said Dr. Nikki Castel, Carondelet St. Joseph’s Hospital’s chief operating officer.

β€œCarondelet’s focus on staffing and filling positions is based not just on today’s census,” she said, β€œbut also taking into account our estimated needs for several weeks from now.”

β€œEmployees going the extra mile”

Since the pandemic started more than eight months ago, hospital leaders here say they’re better prepared to manage workloads as they deal with a disease that’s killed more than 263,000 people nationwide.

That doesn’t mean it’s easy, however.

The pandemic is challenging health-care workers as they try to balance their own lives, health and families with extraordinary demands at work, said Castel of Carondelet St. Joseph’s Hospital, 350 N. Wilmot Road.

β€œYet despite this stress, we saw many examples of employees going the extra mile to support each other,” she said. β€œOur associates, from housekeeping to security to everyone in the clinical professions β€” have been real heroes, being mindful of the care and safety of patients and each other, balancing compassion with patient care and safety.”

When the first wave hit, Dr. Esther Kim remembers, there was so much uncertainty.

β€œWe have learned to stay constantly vigilant with COVID-19 patients β€” even when patients start to make improvements, many times those improvements can be short-lived,” said Kim, co-medical director of critical-care medicine at Northwest Medical Center, 6200 N. La Cholla Blvd.

β€œI think we have learned to go back to basics β€” the basic principles of treating patients in respiratory failure continue to be the most successful.”

Rich, of TMC HealthCare, said while her workforce is β€œexpert, compassionate and caring,” it is also tired as it faces this next wave of coronavirus patients.

β€œWe are focused on addressing the mental, physical and social toll this pandemic has taken on our staff,” she said, β€œincluding providing free counseling and addressing other key stressors they face everyday.”

Work in new and different ways

This surge could be worse than what happened here over the summer, said Dr. Gordon Carr, chief medical officer for clinical outcomes for Banner’s two Tucson facilities who added that he’s still hoping for the best.

As of Friday, Banner statewide was at 88% capacity, not including surge beds for COVID-19 patients. Statewide, ICU bed availability has averaged around 10% for the last week or so as patient numbers climb.

β€œWe’ve been working 24/7 since March to do everything we can to be ready, but given how things are trending,” Carr said, β€œwe also need to remind the community that the best thing all of us can do to make sure that the health-care system is not overwhelmed is to not get sick in the first place.”

Banner is not yet repurposing space for more ICU patients, Carr said. What’s reassuring is that the summer surge taught them how to do it quickly and safely when the time comes, he said.

To deal with the summer surge, he said, Banner turned a vacant area that had once been a post-anesthesia care unit into an ICU, bringing in doctors, nurses and therapists from other areas of the hospital to staff it.

β€œWe’ve done a lot of really intentional work to break down our silos and increase the information we share and increase our ability to do multidisciplinary problem-solving in the moment,” he said. β€œOur ability to coordinate and adapt is better because of the pandemic.”

Another significant change has been to over-communicate and hold β€œhuddles” throughout the day so everyone is hearing about the changes that are in place two or three times, said both Carr and Northwest’s Schomburg.

Several hospital leaders here said they are now monitoring surgeries to make sure they are medically necessary, meaning ones that cannot be delayed without significant risk to the patient. This can help keep more ICU beds open.

Carr said figuring out which surgeries to delay is not always simple.

While some are truly elective, he said, most fall somewhere in the middle, meaning a person might be able to put the surgery off for a couple of weeks or a month, but beyond that it could be harmful to their health.

Kim, of Northwest Medical Center, said it’s critical for the community to understand that when it comes to treating COVID-19, there is β€œno magic bullet.”

β€œWhile we are prepared for this new wave, we are tired. When many people went back to their normal lives over the fall, we did not get a break,” she said.

β€œWe were still here, taking care of all patients who need medical services. We will continue to be here to take care of you, but please help us. Stay at home, be safe, and stay vigilant.”

Become a #ThisIsTucson member! Your contribution helps our team bring you stories that keep you connected to the community. Become a member today.

Contact reporter Patty Machelor at pmachelor@tucson.com or 806-7754. On Twitter: @pattymachstar