Altru Health System's Intensive Care Units and general medical units have been at or near capacity for about seven weeks, though they have not seen a high volume of COVID-19 patients.
When asked how much of a cause for concern that is, Altru Chief Nursing Officer Janice Hamscher said she would put it "somewhere at a medium level."
"This is our normal work," she said. "We manage how patients flow through our organization."
Forum News Service reported on Tuesday, Sept. 29, that as North Dakota continues to lead the nation in per-capita cases of COVID-19, only 22 ICU beds are left available in the state's hospitals. Documents obtained by FNS from the North Dakota Department of Health showed that, on Tuesday, Altru had zero available ICU beds and 17 available inpatient beds.
Those numbers are extremely fluid and change from hour to hour, Hamscher said. While it's true Altru had no available ICU beds on Tuesday, by Thursday morning, Oct. 1, there were 11. But in recent weeks, there's no denying that overall, the hospital has been more full more often.
Frequently, Hamscher sees people make the assumption that the hospital is overrun with COVID-19 patients, but she says that isn't the case. Since the start of the pandemic, she estimates that the hospital has had, at most, 11 COVID-19 patients at one time, and, for the most part, the COVID-19 patients who are admitted to the hospital rarely need critical care and usually are able to recover at home.
Rather, the patients who have filled Altru's beds recently have come through the hospital doors for a wide variety of unrelated reasons.
Hamscher said it's hard to pinpoint a reason for the jump in the number of patients seen in recent weeks.
"My personal thoughts are, have people delayed seeking medical care during COVID, and now they've become more acutely ill and are requiring hospitalization?" she said. "I can't necessarily prove that. But that's my own thought about why we're so busy."
Whatever it is, it's a phenomenon hospitals across the state are seeing. But whether the ICU is full because of COVID-19 patients or non-COVID-19 patients, Hamscher said the result is the same.
When a person seeking care arrives at the hospital, usually through the emergency room, and the ICU is full, here's what happens: As that person receives emergency care, hospital staff assess the beds that are already in use to see which patients could be moved to other units in order to make space for the new patient.
Frequently, that's determined by the availability of nurses and other medical staff more than the availability of physical beds. As is standard for hospitals across the country, Hamscher said Altru commonly runs a tightly staffed operation and never uses all the licensed beds available.
And when moving patients around the hospital, Hamscher said it's important to keep in mind the obvious: Not every member of the medical staff has the same skill set, and a staff member trained to treat a certain kind of patient might not be able to adequately treat another kind of patient.
With those considerations, Hamscher said that if hospital staff members evaluate the number of occupied beds and determine that it's impossible to make space by moving patients around, new patients might be sent to another facility in the region.
As initially reported by The Forum of Fargo-Moorhead in August, Sanford Medical Center in Fargo is among regional hospitals that have received COVID-19 patients from Grand Forks. But by and large, Hamscher said Altru rarely sends patients elsewhere.
"It's just not common," she said.
However, when it does happen, Altru spokeswoman Annie Bonzer said hospital staff might not be aware of it.
"While, in some cases, we are made aware of a patient being diverted to another hospital, often we don’t get that information," Bonzer said. "The regional hospitals and EMS teams are aware of capacities at hospitals and will often make the call on where to transfer a patient."
As of Thursday morning, Altru has 11 staffed ICU beds available, and 24 staffed inpatient beds available. Bonzer said there are seven COVID-19 patients currently in the hospital, and none of them are in the ICU.