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Just two days after narrowly avoiding declaring an internal disaster that would have reported unsafe conditions for patients, lingering staff issues continued to promise a rough night at Scripps Mercy Chula Vista Hospital on Thursday.

By 7 p.m. it was clear that the evening shift would be short of three nurses and five technicians due to positive coronavirus tests and six of the hospital’s 25 emergency beds were already occupied with patients who could not be transferred to already full hospital units.

Although a second overflow tent isn’t ready to vacate beds until Friday, Lornna Hopping, an emergency department patient care manager, said keeping the patient count at 44 for several hours made the situation doable with a little help from a few friends.

“How it goes tonight will depend on personal relationships and what the community brings to our door,” Hopping said.

Emergency room staff check on a patient who was taken by ambulance to Scripps Mercy Chula Vista Hospital.

(Nelvin C. Cepeda / The San Diego Union-Tribune)

It was clear by late afternoon that Scripps’ internal pool of on-call workers would not be able to balance the staff situation, and lately even the incentive to double pay has not been enough to fill vacant positions.

Hopping said that overcoming traffic jams often falls on the nurses in charge of begging, pleading and making whatever deals they can with their colleagues – people they trust who they know will have their backs if they don’t. there’s nowhere to turn.

“At this time of day, these are conversations we’ve had before,” Hopping said. “Someone once said, ‘hey, if I can’t get staff and we’re really short on staff, are you available for a short shift?’ Can I call you? ‘ Hopping said. “Even if they say no, we know who usually doesn’t care.”

Scripps Chula Vista’s ability to come together and support each other was tested on Tuesday when 22 of 24 emergency beds were full with patients who needed to be transferred to already full hospital beds. For a few hours it looked like it would be necessary to declare an internal disaster, a term used when a hospital is forced to stop taking all ambulance deliveries and put in place stricter limits on who will be served. among those who present to the emergency room.

Emergency room staff check on a patient who was taken by ambulance to Scripps Mercy Chula Vista Hospital.

Emergency room staff check on a patient who was taken by ambulance to Scripps Mercy Chula Vista Hospital.

(Nelvin C. Cepeda / The San Diego Union-Tribune)

Returning positive tests among oxygen delivery drivers, dialyzers, trained nursing facility specialists and others have made it extremely difficult for hospitals to remove patients from their wards, causing backups in wards. emergency. A monster case of traffic jam emerged Monday and Tuesday, potentially creating a dangerous condition for patients whose condition deteriorated as they waited to be seen.

Usually, as was the case last winter, other hospitals are able to accept transfers to help a busy facility protect itself from trouble. But at the start of this week, that safety net was so tight that when Scripps Chula Vista called for help, there was simply nothing to give.

“All of my sister hospitals were dealing with the same thing as me; they weren’t able to absorb the patients, ”Hopping said.

Informing superiors of the situation sparked a race to make room. Administrators who do not usually directly care for patients have entered to work and areas have been operated that do not normally contain general admission patients, including the endoscopy room of the hospital where the procedures are performed. gastrointestinal imaging and an area usually reserved for patients recovering from surgery.

Emergency room staff had to use all available spaces to place patients, including hallways.

Emergency staff at Scripps Mercy Hospital Chula Vista had to use all available spaces to place patients, including hallways.

(Nelvin C. Cepeda / The San Diego Union-Tribune)

“We were able to place 20 patients in non-traditional areas, and that helped us get through it,” Hopping said.

Through it all, the patients weren’t always very understanding. Many were frustrated with the long waits and lashed out at workers who were already running on steam.

Dr Juan Tovar, chief operating officer at Scripps Chula Vista, said the early days of the pandemic, when grateful residents passed with cookies and thank you notes, are long gone.

“Patients are less forgiving and patient now, and we experience a lot of verbal and physical abuse,” Tovar said. “If they could just empathize, that would really help. “

Hospitals are doing what they can to increase capacity as demand for non-COVID care continues to arrive alongside more patients with symptoms of COVID-19. At Scripps Chula Vista, workers worked all day to set up a second emergency tent in the parking lot outside the emergency department that could potentially provide space for patients waiting to be admitted to the main hospital. But just setting up tents doesn’t do much without enough workers to deliver the treatment and watch for worsening conditions.

Matthew Luna worked outside in the parking lot where walk-in emergency patients are seen.

Matthew Luna, an emergency technician at Scripps Mercy Hospital Chula Vista, was working outside in the parking lot where walk-in emergency patients are screened.

(Nelvin C. Cepeda / The San Diego Union-Tribune)

On December 30, the California Department of Health released updated quarantine guidelines for healthcare workers, which allow those who are fully vaccinated and boosted to quarantine themselves for only five days, provided they are first negative. And health workers who have tested positive can return to work in less than five days in places with a “critical staff shortage” as long as they are only caring for patients with confirmed coronavirus infections.

So far, Scripps and others have been hesitant to go that far, preferring to quarantine workers for seven days before returning to work.

Chris Van Gorder, chief executive of Scripps, said in an email Thursday afternoon that getting to the point where workers with mild but still active infections are brought back to work is a bridge he’d rather not cross. .

“It’s a fluid situation, and I don’t have a crystal ball,” Van Gorder said. “I would prefer not to do this for security reasons, but I can’t say never either.”

San Diego County reported 5,726 new cases of the coronavirus on Thursday. While that number is significantly lower than the 8,204 positives reported on Wednesday, it is still significantly higher than the one-day grandest last winter.