Staffing and PPE at hospital ‘tight’

But Maui Memorial has enough bed space, bringing in more nurses

Maui Memorial Medical Center currently is "tight" on staffing and personal protective equipment but has 10 backup nurses arriving next week and enough beds to accommodate more patients, hospital officials said Wednesday during a virtual town hall community meeting. 

The meeting comes as the hospital is dealing with its second surge of COVID-19 cases -- 69 total including 31 patients and 38 staff, said spokeswoman Tracy Dallarda after the meeting. Twenty-eight patients remain hospitalized.

The second surge of cases has surpassed the first cluster in April that peaked at 57.

"We are not the only hospital in this state that has experienced this surge," said Maui Health System CEO Mike Rembis during the meeting streamed live on Facebook that attracted as many as 360 watchers. "I know from fact and it has been shared with others, that other hospitals are not only having a high number of positive patients, but they are also having their health care workers unfortunately test positive.

"It's community spread, and we are part of the community, so our employees, our patients are going to test positive, and we are going to deal with it." 

Officials of Maui Health, operators of Maui Memorial, answered questions submitted by the public.

A question about elective surgeries revealed the problem the hospital is having with staffing and PPE. Dr. Michael Shea, Maui Health ICU medical director, said that those surgeries currently are on hold and that their return is dependent on several factors.

"Number one, is do we have the staff, and right now, our staffing is a little tight, because of folks who are out sick," he said. "Number two, is do we have enough personal protective equipment PPE to make sure that we can do all the things we can do in-patient and make sure all the OR (operating room) staff have adequate PPE. Right now, PPE is a little tight so because of those two major reasons at this point we are postponing elective procedures."

Other Maui Health officials said there is sufficient PPE.

About hospital capacity, Chief Nursing Officer Gary Kienbaum said the hospital usually runs at a high capacity level, "but we do have beds available."

Shea said the hospital has 219 licensed beds but could go up to 300. If patient numbers exceed that, Maui Memorial has a tent that can be set up within hours to handle more patients and can seek assistance from the National Guard.

Kienbaum also addressed concerns about ICU capacity. He said that there are 31 critical beds available; one ICU unit has 16 beds for routine critical care and another unit has 15 beds dedicated to COVID care. There is adequate staff who can provide care for those in the ICU.

After the news conference, Dallarda said there were two COVID-19 patients in the ICU on Wednesday. She did not have other patient totals for the ICU.

The hospital had five patients on ventilators but only one was a COVID-19 case, said Kienbaum. There are 32 available regular ventilators, along with other backups.

"We have more than enough ventilators should we need them," Kienbaum said.

While staff may be out of commission due to COVID-19, the hospital had brought in 12 nurses eight weeks ago. At the time, there was a lull in virus cases, but hospital officials felt that they may need them.

The nurses are critical care trained and can work anywhere, but their primary assignment is for COVID-19 patients, he said. There are 10 more nurses on the way next week.

During the livestream, two Maui Memorial nurses spoke about the hospital situation and addressed questions they get asked, like if the hospital has enough supplies and whether they feel safe.

"We have what we need and if it's not there we ask for it," said Taryn, an ICU nurse, who said she was speaking only for her department.

(Hospital officials declined to give the last names of the nurses).

She said her department is strapped for staffing, like other parts of the hospital. Still, they deliver the care that the patients need.

If nurses feel unsafe or need something, they should speak up, Taryn said. "If you don't feel safe, please make it known," she said.

"There is a lot of negativity in the community towards the hospital," she said. "We understand why, however it's a community outbreak, it's spread in the community, we are part of this community.

"We take care of sick community members, so yes, we get sick ourselves and that's unfortunate and it is what it is. We try to do what we can to keep us safe, our patients safe, . . . We are struggling, and we know it, and we are trying the best we can."

Jade is a nurse at the 5th floor Haleakala South, where all the patients are COVID-19 positive. She spoke about her worries about her elderly parents and children, who cannot go to school; coming to work early to be screened; and the container in her car for her shoes to keep them out of her house.

"This pandemic has affected everyone," she said "We try our best to keep our patients and community safe and healthy, but this is something we can't do alone, it's something everyone needs to do in their own part and in their own way.

"I think it would help immensely if you can have some patience and understanding cause like it or not, we are all in this together."

Meanwhile, Hale Makua Health Services on Wednesday reported no new COVID-19 cases, since announcing two cases on Aug. 17. The asymptomatic resident, who had tested positive, continues to be cared for in isolation at Hale Makua Kahului. A home health client, who had tested positive, is no longer being helped by the agency.

The nursing home has tested 23 residents and 61 staff for COVID-19 and all tests have returned negative, a news release said Wednesday. There are no pending tests at this time.

* Melissa Tanji can be reached at mtanji@mauinews.com.