Highlands-Cashiers Hospital staff said they are prepared for an escalation of the COVID-19 pandemic.
“We go through preparatory exercises practicing what we’re going to do at various levels,” said HCH Medical Director Dr. James Wright, MD. “There’s always a next level of escalation, what are you going to do? We’re going to be ready. We have a plan with personnel, patients, and extra physicians and equipment if needed. Everybody is prepared to take the team approach to whatever level it gets to.”
Possible surge of patients
Wright said there were three levels of operation at HCH.
“We have our regular routine, contingency, and crisis,” said Wright. “Crisis mode is the one we don’t want to reach. Crisis mode is a level when you outstrip your resources. Every bed is full, all ventilators are being used, Mission hospital is full. But all 6 hospitals have an eb and flow, I doubt we’ll all be in crisis mode at the same time so there’s always a release valve.”
Administrative Supervisor Hollis Whitehead, RN, often works in the Emergency Department and said in a situation like the COVID-19 pandemic, medical workers and hospitals work together to properly give a patient the care they need.
“The collaboration between hospitals and caregivers is tremendous,” said Whitehead. “We want to come to work, that’s doesn’t change now or a month ago, there’s no difference. Most of us in healthcare are driven by a moral compass. Helping people is what we do, we promote wellness, we help the sick get better. That hasn’t changed for me, that’s still my mission.
Personal protective gear (PPE)
Whitehead said the staff is equipped to safely treat whatever comes their way.
“We have different levels of protection, masks, shields, paprs (powered, air-purifying respirator), gloves, gowns, you name it; we have all of the levels of protection we need,” said Whitehead. “We have plenty of supplies and everything necessary to feel safe. I know our system supports us, we have the equipment, the community is social distancing, and if someone does get sick, we can handle it. We’re in a good position to get them better.”
The National Institutes of Health’s website describes a ventilator as generally used for short periods of time, if a patient goes into surgery and is under anesthesia for example.
Regarding COVID-19, ventilators can help a person having difficulty breathing by getting oxygen into their lungs. Ventilators do not treat an infection; they are used for life support, see more HERE.
HCH has one ventilator and CEO Tom Neal said HCH has access to more if necessary.
“We have backup units we can put into place if need be,” said Neal. “If a patient is unstable and needs a higher level of care, we stabilize and transport them. We’re a critical access hospital, our goal is to stabilize and transfer to another Mission hospital. If a Mission hospital is full, they can send their non-COVID infected patients here.”
Neal said HCH fully supports Governor Roy Cooper’s stay at home order and that data modeling proves stronger social distancing flattens the curve of infection.
“We’ve set up virtual clinics, so established patients are now able to get on an iPhone or some other device and have an appointment with their doctor,” said Neal. “This does two things; it allows people to see their doctor without exposing themselves to getting infected. Second, it makes us more efficient and proactive, and helps us serve the community better than we ever have before. People are encouraged to stay home and call their primary doctor first before coming to the hospital.”
Wright said the best thing people can do right now is follow Cooper’s stay at home order.
“Stay home. Wash your hands. DTYF, don’t touch your face!” said Wright. “The virus has to come into contact with a mucous membrane to get infected. If people have mild flu symptoms, we encourage them to stay home and call their primary physician first.”
Whitehead said people who do not immediately come to the hospital at the first sign of flu symptoms is helping.
“People are paying attention and they’re not coming if they don’t need to, and that’s what we need,” said Whitehead.
Triage tent set up at HCH
A triage tent set up in front of HCH’s ED creates additional capacity for triaging patients outside of emergency departments, should it become necessary as the COVID-19 outbreak evolves.
“All Mission Health facilities have well-established protocols in place to care for patients with infectious diseases, and our emergency planning efforts related to COVID-19 began weeks ago,” said Greg Lowe, President of the North Carolina Division of HCA Healthcare. “While Mission Health has the bed capacity, staffing, supplies and equipment we need at this time, we continue to plan by accessing the resources, support and best practices across HCA Healthcare to help ensure we remain able to meet the needs of the communities we serve as this situation continues to evolve.”
The tents are part of Mission’s standard emergency planning protocols and are simply a precaution at this time. Over the coming days, Mission will conduct training exercises and drills in the tents, allowing caregivers to become comfortable in the environment should the tents need to become operational.
Daily staff updates
Neal said HCH has implemented a universal masking policy and holds daily updates with staff to keep them informed of a situation that changes daily.
“We want them to know what’s going on, and we receive great feedback,” said Neal. “For example, a nurse has young children and was worried about taking her scrubs home after work. Now we wash all the scrubs at the hospital and staff leaves in a clean pair of clothes. Like our universal masking, it’s just one more step to keep our employees safe. We’re going to keep them safe, but we also want them to feel safe.”
Several local restaurants have sent food to hospital staff over the past couple of weeks to show their appreciation for everything healthcare workers are doing during this pandemic.
“The community support has been huge,” said Neal. “Local restaurants sending food to our staff makes a big difference, it says ‘hey, we appreciate you.’ The way they have embraced us throughout this makes us feel wonderful. I think we’ll be a stronger community after this.”
Whitehead said teamwork is essential to make it through this.
“These are some of the best people I’ve had the privilege of working with,” said Whitehead. “It’s what makes our hospital great. And the community sending us food is so uplifting for the staff.”
Wright said part of being in the field of emergency medicine is that anything can happen.
“You have to escalate the intensity of service,” said Wright. “It’s all hands-on deck and everyone does what they need to. Spirits in the hospital are upbeat. They’re in there because they want to help people, they’re absolutely top notch.”
Pictured at the top of the article from left are Wright, Whitehead, and Neal standing in front of the triage tent set up at Highlands-Cashiers Hospital.
Editor’s Note: At no point during the creation of this article were any social distancing guidelines violated. Interviews were done out in the parking lot, well over 6 feet apart. A big thank you to Neal, Whitehead, and Wright for taking the time to speak with me.