“I’ve never seen this level of human suffering in my 20 years of healthcare,” said Chad Montandon, a nurse in the medical intensive care unit at University Medical Center in Lubbock.
Montandon sees the worst of the worst COVID-19 cases. He says It’s been like that since March.
Montandon was coming back from a spring break vacation with his wife and kids when the first case of COVID-19 was detected in Lubbock. They raced home knowing he was needed back at the hospital. The intensity of his job has never subsided.
“One of my more traumatizing moments was taking care of a guy my age, 38 years old.” Montandon said the patient had kids the same age as his own. His voice broke as he recalled his patient’s final moments.
“He’s on a ventilator. He’s face-down.”
To intubate patients in the ICU, nurses flip them on their stomach to help with the airflow from the ventilator. Over time, it causes their faces to swell – they become unrecognizable.
“I’m listening to his kids have a normal conversation with [their dad],” Montandon said. “’Dad you would have been proud of me, I stood up to a bully at school like you taught me.’” That patient died that night,’ Montandon said.
Ebtesam Islam is a pulmonologist in the same unit.
“This is just a monstrosity I don’t think any of us have ever dealt with in our lives,” she said.
“I was anticipating this back in March, I wasn’t anticipating this now.”
Lubbock area hospitals have been running out of staffed beds since the end of November as COVID-19 cases have surged. It’s had a ripple effect beyond the hub city.
Two hours away, Fisher County Hospital sits between Rotan and Roby off Highway 70. Kevin Kelly is one of the nurse practitioners manning the area dedicated to sick patients.
“I consider this the aquarium,” he said, from behind a makeshift wall made from opaque plastic secured to a wooden frame. In the midst of such dire circumstances, Kelly finds levity throughout his daily routine.
Right now, hospital officials say the number of COVID patients they’re treating isn’t the biggest concern. Fisher County hospital is a level four trauma center, meaning they stabilize patients and then rely heavily on transferring patients to higher-level trauma centers like UMC in Lubbock.
Finding hospitals to take their critical patients has become an everyday worry for Kelly.
“Before the pandemic happened it was yes, we’ll take them,” Kelly said.
Now the situation is flipped. There have been times the staff has called 12 different hospitals before finding an open bed.
“They’re apologetic, but they just don’t have the capacity anymore.”
“It’s gut-wrenching,” said Fisher County Hospital CEO, Leanne Martinez. “When you have those critical patients in your facility and there’s nothing you can do.”
She was born and raised in Rotan, a town of about 1,500. As a small, close-knit community, those critical patients she mentions are typically friends or family.
“Because you know everybody, it takes a real emotional toll on our employees,” she said.
The hospital has had to improvise many of their operations throughout the pandemic. The hospital is now limited to two points of entry, the front entrance for sick patients, and the back for well patients.
Fisher County Hospital is licensed for 14 beds, but according to Martinez they can staff eight. The added protocols for COVID have strained their staff even further. With limited equipment like ventilators, they’re worried about what could happen if the situation continues.
Martinez shared a question a member of her staff posed recently. “What are we going to do if we have an intubated patient that we can’t get a bed for?” She ansered, “We’re going to keep them on our [ventilator] as long as we can. If we don’t have a vent, we’re going to sit there and we’re going to bag them…we’re going to bag them until we can’t bag them anymore.”
Bagging a patient would mean the medical staff would take turns hand pumping oxygen into their lungs. Martinez said they would have about three hours to transfer that patient.
“This is a very real, sad and tragic problem that we are experiencing,” said Don McBeath, the Advocacy Director for the Texas Organization of Rural and Community Hospitals, or TORCH.
“People are dying in rural hospitals because they cannot be transferred to hospitals where they can provide higher levels of care,” he said
Like Fisher County, rural areas across Texas are struggling with this situation. McBeath says he gets reports daily from at least one rural hospital unable to find a bed for a critical patient.